螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值

Diagnostic Value of Spiral CT Head and Neck Angiography on Carotid Artery Stenosis in Patients with Acute Cerebral Infarction

目的:探讨螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值。方法:选取2014年1月至2016年1月期间来我院就诊的60例急性脑梗死患者作为观察组,另选同期来我院就诊的非急性脑梗死患者60例作为对照组。两组患者均进行螺旋CT头颈部血管成像检查,比较两组患者的颈动脉狭窄程度及各段血管斑块分布情况,并根据检查结果评价螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值。结果:观察组轻度狭窄与中度狭窄检出率均显著高于对照组(P<0.05),重度狭窄与闭塞检出率与对照组比较无统计学差异(P>0.05),观察组总检出狭窄率高于对照组(P<0.05)。观察组与对照组在颈动脉分叉处、颈总动脉、颈内动脉及颈外动脉均有斑块检出,观察组斑块总检出率为69.4%,显著高于对照组的41.2%(P<0.05)。结论:临床上应用128层螺旋CT头颈部血管成像技术对急性脑梗死患者颈动脉狭窄情况可进行有效评估,该方法对患者轻、中度狭窄以及双侧颈动脉斑块检出率更高,在临床诊断及预后防治中具有应用推广价值。

Objective： To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction. Methods： A total of 60 patients with acute cerebral infarction（ACI）, who were treated in Affiliated Hospital of Yan＇an University from January 2014 to January 2016, were selected as observation group, and 60 patients with non-acute cerebral infarction, as control group. The two groups of patients underwent spiral CT head and neck angiography. The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated. Results： The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group （P〈0.05）, while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group （P〉0.05）. The total detection rate of stenosis in the observation group was higher than that in the control group （P〈0.05）. There were plaques detected in the carotid bifurcation, common carotid artery, internal carotid artery and external carotid artery in the two groups. The total detection rate （69.4%） of the observation group was significantly higher than that （41.2%） of the control group （P〈0.05）. Conclusion： Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction. This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI, and it has application value in the clinical diagnosis and prognosis.