缺血性脑血管病病变血管的CTA检查价值

The CTA Examinational Value of Vascular Lesions in Ischemic Cerebrovascular Disease

目的:探讨缺血性脑血管病病变血管的CTA检查价值。方法:使用Philips Brilliance 16层螺旋CT机,Philips Extended Brilliance TM Workspace或GE AW4.4图像后处理工作站,以MIP、CPR为主,VR为辅,对头颈部动脉进行分析,观察缺血性脑血管病病变血管的形态学改变。结果:102例缺血性脑血管病中有90例发现病变血管(占88.24%),90例中,单纯脑动脉病变57例(占63.33%),单纯颈动脉狭窄、斑块12例(占13.33%),脑动脉及颈动脉联合病变21例(占23.33%)。病变血管的CTA表现:检出的78例脑动脉病变中,24例显示为动脉粥样硬化性改变,38例显示为较明确的局限性血管狭窄,其中6例可见斑块,16例显示为血管闭塞,均在大脑中动脉。检出的33例颈动脉病变中,显示为血管狭窄、斑块形成以及血管壁钙化,均位于颈动脉分叉处及颈内动脉起始部。各种缺血性脑血管病与病变血管的对应关系:48例脑梗死,29例找到责任血管;26例TIA,22例找到病变血管;19例腔隙性脑梗死,16例可见不同程度的颈、脑动脉病变;9例有临床表现而CT和(或)MRI显示正常者,显示脑、颈动脉病变6例。结论:CTA可作为缺血性脑血管病的常规检查方法,用来评价缺血性脑血管病病变血管的形态学改变。

Purpose： To investigate the CTA examinational value of the vascular lesions caused by ischemic cerebrovascular disease. Methods： Use Philips Brilliance＇s 16-slices helical CT, Philips Extended Brilliance TM Workspace or GE AW4.4 Image post-processing workstations, mainly by MIP and CPR, supplied by VR, to do some analysis of neck and cranial artery, then observe the morphologic changes of the vascular lesions in ischemic cerebrovascular disease. Results： 90 of the 102 ischemic cerebrovascular diseases have been found vascular lesions（88.24%）, in the 90 vascular lesions, there were 57 pure cerebral artery diseases（63.33%）, 12 pure carotid artery stenosis and plaques（13.33%）, 21 combined lesions of cerebral arteries and carotid arteries（23.33%）. The CTA performance of vascular lesions： from the 78 detected cases of cerebral artery disease, 24 were showed of atherosclerotic changes, 38 were showed of clearer limited hemal stricture, 6 cases of which could be seen patches, 16 were showed of vascular occlusion, all happened in the middle cerebral artery. In the 33 detected cases of carotid artery disease, those were showed of hemal stricture, plaque formation and hemal wall calcification, all located in the carotid arterial bifurcation and the initial part of internal carotid artery. The relationship of varieties of the ischemic cerebrovascular diseases and the vascular lesions： 48 cases of cerebral infarction, 29 have been found responsible vessels; 26 TIA, 22 have been found vascular; 19 cases of lacunar cerebral infarction,16 of which could see different levels of carotid artery and cerebral artery diseases. 9 cases had clinical manifestations but were found normal through CT and（or） MRI, 6 showed of cerebral and carotid artery diseases. Conclusion： CTA can be the routine examination method of ischemic cerebrovascular diseases, so as to evaluate the morphologic changes of the vascular lesions in ischemic cerebrovascular diseases.