MDCT对颈部动脉不同性质斑块分布特征的研究

Carotid atherosclerotic plaque distribution characteristics with different property based MDCT

目的通过多排螺旋CT血管成像分析不同性质颈部动脉粥样硬化斑块的分布特点,特别是左右颈动脉之间的分布差异。方法回顾性分析278例CTA显示具有颈部动脉血管斑块的患者,根据斑块的不同性质(软斑、钙化斑块、混合斑块)、不同颈部血管位置(颈总、颈内、颈总分叉、颈内分叉、颈总起始和颈内起始)进行分析;并对不同性别和左右侧不同性质和位置的斑块进行分析,采用χ2检验,最终评估斑块的分布特征。结果 278例患者中,颈总动脉分叉处的软斑、钙斑及混合斑块发生率最高,分别为113处(35.3%)、42处(46.7%)、137处(44.8%),在左侧和右侧分析中,左侧软斑块的发生138处明显高于右侧101处(P<0.05),同时,左侧颈总动脉61处(62.2%)与右颈总动脉37处(37.8%)软斑分布差异有统计学意义(P<0.05);男性各种类型斑块的发生率明显高于女性(P<0.05)。结论颈动脉不同性质的硬化斑块在发生部位有一定规律,探讨不同性质颈动脉硬化斑块的特点对脑内血管缺血性疾病的预测及神经介入治疗有指导作用。

Objective To analyze the distribution characteristics of carotid atherosclerotic plaque with different properties, especially between left and right carotid artery by multi detector CT （MDCT） angiography. Methods 278 patients who underwent CT carotid artery angiography were retrospectively recruited to evaluate the imaging features of carotid artery plaques. The plaque characteristics were analyzed by different properties and different locations. According to plaque property, it divided to soft plaque, calcified plaque and mixed plaque. According to plaque location, it divided to common carotid artery, internal carotid, bifurcation of common carotid artery, bifurcation of internal carotid, start of common carotid artery and start of internal carotid. In different sex, carotid vascular position were analyzed by X2 test. Results In 278 patients, the incidence of soft plaque, calcium plaque and mixed plaque on bilateral bifurcation of common carotid artery was highest, 113 （35.3%）, 42 （46.7%） and 137 （44. 8% ） respectively. The incidence of soft plaque on the left side 138 （57.7%） was significantly higher than those on the right side 101 （42. 3% ）. At the same time, soft plaque in the left common carotid artery 61 （62.2%） and right common carotid artery 37 （37.8%） distribution was obviously different（P 〈 0.05 ）. Male incidence of all types of plaque was obviously higher than that in female （ P 〈 0.05 ）. Conclusion Location distribution of carotid atherosclerosis plaque with different properties has certain regularity. To explore the characteristics of carotid atherosclerosis plaque with different properties can predict brain ischemic vascular disease and has a guiding role in nerve interventional therapy.