超声在颈内动脉狭窄与无症状性脑梗死相关性研究中的应用

Application of ultrsonography in studying the correlation between internal carotid artery stenosis and asymptomatic cerebral infarction

目的利用超声分析颈内动脉狭窄与双侧大脑半球无症状性脑梗死(asymptomatic cerebral infarction,ACI)的关系,为ACI的诊断和治疗提供重要影像学依据。方法对365例ACI患者行颈动脉超声及头部核磁共振成像(magnetic resonance imaging,MRI)检查,分析ACI与颅外段颈内动脉狭窄的相关性。结果颈内动脉狭窄同侧大脑半球ACI发生率明显高于对侧(P<0.001),腔隙性ACI患者两侧大脑半球发生率差异无统计学意义(P=0.617),而皮质ACI患者双侧大脑半球发生率差异有统计学意义(P<0.001);颈内动脉狭窄程度不同时皮质ACI发生率差异有统计学意义(P<0.001)。结论 ACI患者中,皮质ACI与同侧颈内动脉狭窄有显著相关性,而腔隙性ACI与同侧颈内动脉狭窄无明显相关;不同程度颈内动脉狭窄的患者,皮质ACI的发生率不同,以颈内动脉闭塞时皮质ACI发生率最高。

Objective To analyze the relationship between internal carotid stenosis and asymptomatic cerebral infarction(ACI） using ultrasound,and to provide important imaging evidence for the diagnosis and treatment of ACI. Methods Carotid artery color Doppler ultrasound and MRI were performed in 365 asymptomatic cerebral infarction patients,and the correlation between ACI and extracranial internal carotid artery stenosis was analyzed. Results The incidence of ACI in the ipsilateral cerebral hemisphere was significantly higher than that in the contralateral side(P〈0. 001）,and there was no significant difference in the prevalence of lacunar ACI between bilateral hemispheres(P = 0. 617）. However,there was significant correlation between cortical ACI and ipsilateral internal carotid artery stenosis(P〈0. 001）,and there was significant difference in the incidence of ACI in different degree of carotid artery stenosis(P〈0. 001）. Conclusion In patients with ACI,cortical ACI demonstrates high relativity with ipsilateral internal carotid artery stenosis,and there is no obvious correlation between lacunar ACI and ipsilateral internal carotid artery stenosis. The incidence of cortical ACI is different in patients with different degrees of internal carotid stenosis,and which is the highest in patients with internal carotid artery occlusion.