头颈CT血管造影对急性缺血性脑卒中责任血管检出效果及诊断价值研究

Study on the detection effect and diagnostic value of head and neck CTA in responsible vessels of acute ischemic stroke

目的探讨头颈CT血管造影(CTA)对急性缺血性脑卒中责任血管检出效果及诊断价值。方法选取自2017年2月至2018年12月收治的312例急性缺血性脑卒中患者为研究对象,采用常规CTA对患者头颈血管进行检查,观察患者责任血管分布、动脉狭窄程度、斑块部位及性质。结果患者动脉狭窄检出率为79.5%(248/312)。责任血管为大脑中动脉的患者最多,占42.0%(131/312);责任血管为大脑后动脉的患者最少,占1.9%(6/312)。血管狭窄共计859处,其中,颈总动脉分叉处狭窄最多,占21.30%(183/859),基底动脉狭窄最少,占2.56%(22/859),血管轻度及中度狭窄显著多于重度及闭塞。血管斑块共计554处,钙化斑块检出率为60.29%(334/554),显著多于非钙化斑块的31.59%(175/554),差异有统计学意义(P<0.05)。结论头颈CTA可诊断急性缺血性脑卒中患者的责任血管、血管狭窄程度,判断患者斑块性质,具有较高的临床诊断价值。

Objective To investigate the effect and diagnostic value of head and neck CT angiography(CTA)in the detection of responsible blood vessels in acute ischemic stroke.Methods A retrospective study was performed on 312 cases of patients with acute ischemic stroke who were admitted from February 2017 to December 2018.The head and neck blood vessels of the patients were examined by conventional CTA,and the distribution of responsible blood vessels,degree of arterial stenosis,location and nature of plaques were observed.Results The detection rate of arterial stenosis was 79.5%(248/312).The middle cerebral artery was 42.0%(131/312),responsible for the largest number of patients,and the posterior cerebral artery was(1.9%,6/312),the least.There were 859 vascular stenosis sites,among which the common carotid artery stenosis was the largest(21.30%,183/859)and basilar artery stenosis was the least(2.56%,22/859).The mild and moderate vascular stenosis was significantly more than the severe and occlusional stenosis.The total number of vascular plaques was 554,and the detection rate of calcified plaques was 60.29%(334/554),which was significantly higher than that of non-calcified plaques(31.59%,175/554),with statistically significant difference(P<0.05).Conclusion Head and neck CTA can accurately diagnose the degree of responsible vessels and vascular stenosis in patients with acute ischemic stroke,and judge the nature of plaques in patients,which has high clinical diagnostic value.