MSCTA对后循环缺血椎-基底动脉粥样斑块的诊断价值

The value of MSCTA in the diagnosis of posterior cerebral ischemia atheromatous plaques

目的探讨多排螺旋CT血管造影(MSCTA)对后循环缺血的椎-基底动脉粥样斑块和狭窄程度的诊断价值。方法对53例后循环缺血患者行MSCTA检查。应用原始图像、MIP和CPR图像寻找斑块,探讨椎-基底动脉粥样斑块发生部位、数量、成分、性质、动脉狭窄程度。结果53例中,共发现83处斑块。其中,椎动脉颅内段、三段、二段、起始段、基底动脉、大脑后动脉分别35处、9处、4处、16处、16处、3处。软斑块41处(49.4%),混合斑块18处(21.7%),钙化斑块24处(28.9%)。轻、中、重度狭窄、闭塞分别29处,51处、15处、10处。斑块表面不规则15处,斑块溃疡9处。结论 MSCTA可充分显示后循环缺血的椎-基底动脉粥样斑块发生情况和动脉狭窄程度,为其诊断和治疗提供可靠的依据。

Objective To investigate the value of multi-slice spiral CT angiography（MSCTA） in the diagnosis of posterior cerebral ischemia atheromatous plaques. Methods MSCTA was performed in 53 patients with posterior cerebral ischemia. The occurrence of atheromatous plaques and stenosis were evaluated with the original image,MIP and CPR images. Results A total of 83 plaques was diagnosed in 53 cases, of which 35 plaques located at intracranial vertebral artery, 9 plaques at three sections, 4 plaques at the second initial segment, 16 plaques at the first initial segment, 16 plaques at basilar artery, 3 plaques at posterior cerebral artery. Soft plaques accounted for 49.4%, mixed plaques for 21.7% ,and calcified plaques for 28. 9%. Light, moderate and severe stenosis were 29,59 and 18 places, respectively. Eleven arteries were found to be occluded. Plaque surface was irregular in 15 plaques and with ulcers in 9 plaques. Conclusion MSCTA can clearly show the occurrence,location,quantity, composition, nature of the plaques and arterial stenosis in the vertebral artery with posterior cerebral ischemia.