头颈部CT血管成像对脑梗死与颈脑动脉狭窄的关系研究及危险因素相关分析

Study on relationship between cervicocerebral CT angiography with cerebral infarction and carotid and cerebral artery stenosis and correlation analysis of risk factors

目的通过128层CT血管成像(CTA)对脑梗死与颈脑动脉狭窄之间的关系进行研究,并对危险因素进行相关分析。方法回顾性分析2011年9月至2012年10月收治的颈脑血管疾病患者606例的临床资料。采用128层CTA发现颈脑动脉狭窄患者,按有无脑梗死分脑梗死组及无脑梗死组;用多种后处理技术进行血管后处理并进行对比分析。结果颈内动脉狭窄所占比例最高(24.00%),其次为颈外动脉起始部狭窄(12.79%),椎基底动脉狭窄最少(5.57%)。左侧颈脑动脉狭窄明显高于右侧。颈动脉狭窄最好发部位为颈内外动脉起始部。双侧大脑中、后动脉狭窄发生率高于大脑前动脉。脑梗死组颈脑动脉狭窄发生率明显高于无脑梗死组,两组间差异有统计学意义(P<0.01)。脑梗死组非钙化斑块检出率高于无脑梗死组,差异具有统计学意义(P<0.05)。结论脑梗死的发生与颈脑动脉狭窄密切相关,颈脑动脉狭窄处斑块部位、范围、数量、性质、狭窄程度是脑梗死的重要危险因素。

Objective To study the relationship between 128-slice spiral computed tomography angiography （128-SCTA） with cerebral infarction and carotid and cerebral artery stenosis and to perform the correlation analysis of risk factors. Methods The patients with carotid and cerebral artery stenosis discovered by 128-SCTA were divided into the cerebral infarction group and non-cerebral infarction group. The various postprocessings techniques were per- formed to conduct the vascular postprocessing and the comparaive analysis. The clinical data in 606 cases of cervicoce- rebral vascular diseases treated from September 2011 to October 2012 were performed the retrospective analysis. Re- suits The proportion of internal carotid arterial stenosis had the highest proportion（24.00 %）, followed by external carotid arterial stenosis（ 12. 79 %） and vertebrobasilar arterial stenosis was least （5. 57 %）. Cervicocerebral arterial stenosis in the left side was significantly higher than that in the right side. The initial part of internal and external ca- rotid arterial stenosis was the most common sites of involement. The incidence rate in bilateral middle, posterior cere- bral arterial stenosis was higher than that in the anterior cerebral arterial stenosis. The incidence rate of cervicocere- bral arterial stenosis in the cerebral infarction group was significantly higher than that in the non-cerebral infarction group,the difference between the two groups showing statistical significance（P〈0.01）. The non-calcified plaque de- tection rate in the cerebral infarction group was significantly higher than that in the non-cerebral infarction group, the differences between them was statistically significant （P〈0.05）. Conclusion The cerebral infarction occurrence is closely related with cervicocerebral artery stenosis. The location, range, quantity, character and stenosis degree of plaque in the cervicocerebral arterial stenosis are the important risk factors of cerebral infarction.