256层多层螺旋CT血管造影术对颈动脉粥样斑块稳定性的评价

Evaluation of 256 Slice Spiral CT Angiography on Stability of Carotid Atherosclerotic Plaques

目的探讨多层螺旋CT血管造影对颈动脉狭窄和粥样斑块的诊断价值。方法回顾性分析行多层螺旋CT检查356例患者临床资料,结合患者临床症状,由3名放射科高年资医师采用MIP、VR、CPR及高级血管分析(AVA)等方法分别对颈脉动狭窄程度、斑块位置分布、构成成分等进行评价。结果颈动脉病变与脑缺血症状具有明显相关性(χ2=13.41,P=0.002),狭窄程度>30%时脑梗死组与无症状组比较差异明显(P<0.01),动脉狭窄<30%溃疡型斑块率3.13%,而>30%溃疡型斑块率19.41%,经Fisher精确概率法卡方检验,两者差异极显著(P<0.01)。结论 256层螺旋CT不仅能准确判断颈动脉狭窄程度,而且可对导致动脉狭窄的粥样斑块形态进行准确预测,可对临床治疗方案的选择提供有效依据。

Objective To evaluate the value of 256 slice spiral CT angiography in the diagnosis of carotid artery stenosis and atherosclerotic plaque.Methods We did the retrospective analysis for clinical data of 356 patients treated with multi-slice spiral CT. Three experienced physicians from radiological department employed MIP,VR,CPR and advanced vessel （AVA） on the basis of clinical symptoms to evaluate the level of carotid artery stenosis, plaque distribution and structures.Results There was a significant correlation beween carotid artery disease and cerebral ischemia symptoms （X2= 13.41, P = 0.002）. The cerebral infarction group and asymptomatic group had significant difference while the stenosis level was greater than 30% （P〈0.01）. When the stenosis level was less than 30%, the ulcerative plaque rate was 3.13%, but when the ste- nosis level was greater than 30%, the ulcerative plaque rate was 19.41%.After the test of FISH- ER exact probability X,the difference was significant （P〈0.01）. Conclusions 256 slice spiral CT can accurately determine the degree of carotid artery stenosis, predict the atherosclerotic plaque which led to the artery stenosis,and provide effective references for clinical treatment.