基于多层螺旋CT血管造影技术评估不同重构模式的症状性颈动脉斑块特征

Evaluation of symptomatic carotid plaque characteristics in different carotid artery remodeling patterns based on multilayer spiral CTA

目的探讨多层螺旋CT血管造影(CT angiography,CTA)技术比较不同重构模式的症状性颈动脉斑块形态学及成分构成的相关特征。方法回顾性分析2016年1月~2020年10月在北京朝阳医院京西院区因症状性颈动脉就诊,并经CTA检查筛出颈动脉存在惟一责任斑块的患者129例,根据不同的重构模式分为正性重构组61例和负性重构组68例,比较2组斑块相关指标的差异。结果2组斑块长度和斑块溃疡比例比较,无统计学差异(P>0.05)。与负性重构组比较,正性重构组斑块负荷(0.62±0.26 vs 0.47±0.06,P=0.000)、斑块偏心指数(0.77±0.02 vs 0.68±0.03,P=0.016)和斑块脂质成分体积[434.50(226.80,704.90)mm^(3) vs 226.25(157.50,391.48)mm^(3),P=0.000]更大,差异有统计学意义。结论多层螺旋CTA技术可快速准确评价斑块的形态和成分构成,对危险斑块的筛出具有重要的临床意义。

Objective To compare the morphological and compositional characteristics of symptomatic carotid plaques in different carotid artery remodeling patterns based on multilayer spiral CTA.Methods One hundred and twenty-nine patients with their symptomatic carotid plaques detected by multilayer spiral CTA in our hospital from January 2016 to October 2020 were divided into positive remodeling group(n=61)and negative remodeling group(n=68).The parameters of carotid plaques were compared between the two groups,including the plaque length,plaque burden,plaque surface ulceration,plaque eccentricity index,plaque lipid component volume.Results No significant difference was detected in plaque length and plaque surface ulceration between the two groups(P>0.05).The plaque burden was significantly heavier(0.62±0.26 vs 0.47±0.06,P=0.000),the plaque eccentricity index was significantly higher(0.77±0.02 vs 0.68±0.03,P=0.016),and the plaque lipid component volume was significantly larger[434.50(226.80,704.90)mm^(3) vs 226.25(157.50,391.48)mm^(3),P=0.000]in positive remodeling group than in negative remodeling group.Conclusion Multilayer spiral CTA can rapidly and accurately evaluate the morphological and compositional characteristics of symptomatic carotid plaques,thus playing an important role in identification of them.