DWI联合双能量CTA研究急性腔隙性脑梗死与颈部动脉粥样硬化的相关性

DWI Combined with Dual-energy CTA to Study the Relationship between Acute Lacunar Infarction and Carotid Atherosclerosis

目的探讨颅脑扩散加权成像联合颈部双能量CT血管造影在急性腔隙性脑梗死与颈部动脉粥样硬化相关性研究中的应用价值。方法选取我院212例临床疑似急性LI患者24 h内完成DWI及颈部双能量CTA检查,记录急性LI灶分布、数目,分析颈部动脉粥样硬化斑块的性质及相应病变血管的狭窄程度。结果急性LI男性发病率为69.92%,高于女性的55.70%,差异具有统计学意义(P<0.05),但急性LI灶分布、数目无性别差异(P>0.05)。212例研究对象中,急性LI阴性组、单发急性LI组与多发急性LI组斑块发生率分别为56.00%,72.09%,76.47%,三组比较,差异具有统计学意义(P<0.05),而单发急性LI组与多发急性LI组的斑块发生率比较,差异无统计学意义(P>0.05)。212例研究对象共有755段颈部动脉发现粥样硬化斑块,急性LI阴性组、单发急性LI组与多发急性LI组患者的斑块位置比较,差异无统计学意义(P>0.05)。单发急性LI组与急性LI阴性组、多发急性LI组与LI阴性组的粥样硬化斑块性质比较,差异具有统计学意义(P<0.05)。急性LI灶数目与动脉狭窄程度的Spearman相关系数=0.328(P<0.05)。结论急性LI者的颈部动脉粥样硬化斑块发生率高于急性LI阴性者,急性LI灶数目与动脉狭窄程度存在弱正相关性。

Objective To investigate the value of diffusion-weighted imaging combined with cervical dual energy CT angiography in the study of the correlation between acute lacunar infarction and carotid atherosclerosis. Methods The DWI and cervical dual-energy CTA were performed in 212 patients with clinically suspected acute LI in our hospital.The distribution and number of acute LI lesions were recorded.The nature of cervical atherosclerotic plaque and the degree of stenosis of the corresponding lesions were analyzed.Results The incidence rate of acute LI male was 69.92%,which was higher than that of female 55.70%,the difference was statistically significant（P〈0.05）,but there was no gender difference in the distribution and number of acute LI lesions（ P 〉0.05）.Among the 212 subjects,the incidence of plaque in acute LI-negative group,single-shot acute LI group and multiple acute LI group were 56.00%,72.09%,and 76.47%,respectively,and the difference was statistically significant（P 〈0.05）.There was no significant difference in the incidence of plaque between the single acute acute LI group and multiple acute LI group（P 〉0.05）.In 212 cases,there were 755 segments of the carotid artery atheromatous plaque.There was no significant difference in plaque location between the acute LI negative group,the single acute LI group and the multiple acute LI group（P〈0.05）.The characteristics of atherosclerotic plaque in acute LI group and acute LI negative group,multiple acute LI group and LI negative group were statistically significant（ P〈0.05）.The Spearman＇s correlation coefficient between the number of acute LI lesions and the degree of arterial stenosis was 0.328（ P〈0.05）.Conclusion The incidence of cervical atherosclerotic plaque in patients with acute LI is higher than that in acute LI negative patients.There is a weak positive correlation between the number of acute LI lesions and the degree of arterial stenosis.