多层螺旋CT与MR诊断颈动脉狭窄和粥样硬化斑块的临床价值

Clinical value of multi-slice spiral CT and MR in the diagnosis of carotid stenosis and atherosclerotic plaque

目的观察和比较多层螺旋CT与MR诊断颈动脉狭窄和粥样硬化斑块的临床价值。方法选取2018年1月至2018年12月我院收治54例脑血管缺血性疾病患者为研究对象,均行多层螺旋CT和MR检查。以数字减影血管造影的诊断结果为金标准,比较多层螺旋CT和MR诊断颈动脉狭窄程度和粥样硬化斑块的价值。结果 54例患者行多层螺旋CT检查显示无狭窄10例,轻度狭窄16例,中度狭窄14例,重度狭窄8例,完全闭塞6例;行MR检查显示无狭窄10例,轻度狭窄17例,中度狭窄14例,重度狭窄9例,完全闭塞4例。多层螺旋CT诊断颈动脉狭窄程度准确度为61.11%,与MR的64.81%比较,差异不显著(P>0.05)。54例患者行多层螺旋CT检查显示易损性斑块29例,稳定性斑块25例;行MR检查显示易损性斑块30例,稳定性斑块24例。MR诊断颈动脉粥样硬化斑块的准确度为83.33%,明显高于多层螺旋CT的66.67%(P<0.05)。结论多层螺旋CT和MR均能较好的显示颈动脉狭窄程度,且MR可更好地显示颈动脉粥样硬化斑块的情况,临床应用价值更高。

Objective To observe and compare the clinical value of multi-slice spiral CT and MR in the diagnosis of carotid stenosis and atherosclerotic plaque. Methods Fifty-four patients with cerebrovascular ischemic diseases admitted in our hospital from January 2018 to December 2018 were selected as the research objects, and all of the patients received multi-slice spiral CT and MR examination. The diagnostic results of digital subtraction angiography were taken as the gold standard, and the value of multi-slice spiral CT and MR in the diagnosis of carotid stenosis and atherosclerotic plaque were compared. Results Multi-slice spiral CT examination results of 54 patients showed that no stenosis in 10 cases, mild stenosis in 16 cases, moderate stenosis in 14 cases, severe stenosis in 8 cases and complete occlusion in 6 cases;MR examination results showed that no stenosis in 10 cases, mild stenosis in 17 cases, moderate stenosis in 14 cases, severe stenosis in 9 cases and complete occlusion in 4 cases. The accuracy rate of multi-slice spiral CT in the diagnosis of carotid stenosis was 61.11%, which had no statistically significant difference compared with 64.81% of MR (P>0.05). Multi-slice spiral CT examination results of 54 patients showed that vulnerable plaques in 29 cases and stable plaques in 25 cases;MR examination results showed that vulnerable plaques in 30 cases and stable plaques in 24 cases. The accuracy rate of MR in the diagnosis of carotid atherosclerotic plaque was 83.33%, which was significantly higher than 66.67% of multislice spiral CT (P<0.05). Conclusion Both multi-slice spiral CT and MR can better show the degree of carotid stenosis, and MR can better show the situation of carotid atherosclerotic plaque, and has higher clinical application value.