256iCT颈动脉血管成像对颈动脉狭窄及斑块定量分析

Quantitative study of carotid artery stenosis and atherosclerotic plaque by 256-slice carotiangiography

目的采用256i CT血管造影对颈动脉狭窄定量分析,探讨多排螺旋CT血管成像(MSCT)对颈动脉狭窄诊断的临床应用价值。方法分析于本院接受256i CT颈动脉造影检查573例,男性332例,女性241例,平均年龄57.22±13.02岁。采用多平面重建(MPR)、最大密度图像(MIP)及容积再现(VR)等技术分别测量及统计颈总动脉、颈内动脉动脉粥样硬化斑块部位、性质及局部管腔的狭窄程度。结果 573例患者中,共检测颈部动脉2292支,颈动脉血管狭窄1175支,其中轻度狭窄1054支,中度狭窄57支,重度狭窄64支。颈内动脉较颈总动脉易发生狭窄(p<0.05),中度以上狭窄病灶多见于颈内动脉(p<0.05);颈总动脉较颈内动脉多见非钙化斑(p<0.05);颈内动脉较颈总动脉多见钙化斑及混合斑(p<0.05)。左、右两侧颈总、颈内动脉狭窄的发生率、斑块的性质比较差异无统计学意义(p>0.05)。结论 256i CT颈动脉造影能清晰显示颈动脉狭窄的程度及斑块性质,具有快速、无创及直观等特点,可以作为颈动脉狭窄筛查的常规检查方法。

Objective To evaluate the clinical value in carotid artery stenosis and atherosclerotic plaque on 256-slice spiral CT angiography （CTA）. Methods Retrospectively analysed 573 patients by 256-slice spiral CT carotid angiography, male 332, female 241, with mean age 57.22-＋ 13.02 years old. and the location and degree of stenosis and artery atherosclerotic plaque characteristics in carotid were measured using 3D-process soflwareincluding multi-planar reconstruction（MPR） and maximum density projection （MIP） and volume rendering（VR） ）technique by 256iCT. Results 2292 carotid arteries in 573 cases were evaluated. 1175 branches stenosis vessels were diagnosed, including mild stenosis 1054 branches, moderate stenosis 57 branches and serious stenosis 64 branches. Internal carotid artery（ICA） stenosis were more common than carotid artery （CCA） stenosis （p〈0.05）. There were more often inabove moderate stenosis in ICA than that in CCA （p〈0.05）. Non calcified plaque in CCA were more apepeared than those in ICA （p〈0.05）. Calcified plaque and mixed plaque in ICA were more appeared than those in CCA （p〈0.05）.There was no difference between left and right CCA or ICA in stenosis incidence and the quality of plaque （p〉0.05）. Conclusions 256-slice CT carotid angiogTaphy can be clearly displayed the degree and quality of carotid artery stenosis. It can be used as a non-invasive method screening carotid artery stenosis in routine examination.