多层螺旋CT血管造影对颅内缺血性改变颈动脉粥样硬化斑块形态特征的评估价值

Value of multi-slice spiral CT angiography in evaluating the morphological characteristics of carotid atherosclerotic plaques in patients with intracranial ischemic changes

目的探讨多层螺旋CT血管造影(MSCTA)对颅内缺血性改变患者颈动脉粥样硬化斑块形态特征的评估价值。方法回顾性选取颅内缺血性改变且行颈动脉MSCTA检查的患者40例并纳入研究组,同时将同期未发生颅内缺血性改变且行MSCTA检查的患者40例纳入对照组。比较2组颈动脉狭窄程度、颈动脉粥样硬化斑块检出率、斑块形态、斑块内溃疡、环形征阳性率、颈动脉重构率等,统计研究组预后不良发生率,采用Logistic回归模型分析颈动脉MSCTA检查结果独立评估患者预后不良风险的价值。结果研究组的中重度颈动脉狭窄患者占比、颈动脉粥样硬化斑块检出率、不规则型斑块率、溃疡型斑块率、环形征阳性率、颈动脉重构率均高于对照组,轻度狭窄及无狭窄患者占比低于对照组,差异有统计学意义(P<0.05)。研究组预后不良发生率为27.50%(11/40)。研究组中,预后良好患者与预后不良患者的MSCTA检查结果比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,研究组MSCTA检查结果可独立有效评估患者的预后不良发生风险。结论MSCTA可有效评估颅内缺血性改变患者颈动脉粥样硬化斑块形态特征和颈动脉狭窄程度,且MSCTA检查结果可独立评估患者预后不良发生风险。

Objective To investigate the value of multi-slice spiral CT angiography(MSCTA)in evaluating the morphological characteristics of carotid atherosclerotic plaques in patients with intracranial ischemic changes.Methods A total of 40 patients with intracranial ischemic changes who underwent carotid artery MSCTA examination were retrospectively selected as study group,and 40 cases patients without intracranial ischemic changes during the same period who underwent MSCTA examination were selected as control group.The degree of carotid artery stenosis,detection rate of carotid atherosclerotic plaque,plaque shape,intraplaque ulcer,positive rate of ring sign,reconstruction rate of carotid artery of two groups were compared.The rate of poor prognosis in the study group was recorded.Logistic regression model was used to analyze the value of carotid artery MSCTA examination results in independently evaluating the risk of poor prognosis.Results Compared with the control group,the proportion of patients with moderate to severe carotid stenosis,the detection rate of carotid atherosclerotic plaque,the rate of irregular plaque,the rate of ulcer plaque,the positive rate of ring sign,and carotid artery remodeling rate in the study group were higher,while the proportions of patients with mild stenosis and without stenosis were lower(P<0.05).The rate of poor prognosis in the study group was 27.50%(11/40).In the study group,MSCTA examination results showed significant difference in patients with good prognosis and those with poor prognosis(P<0.05).Logistic regression analysis showed that MSCTA examination results in the study group can effectively and independently assess the risk of poor prognosis.Conclusion MSCTA can effectively assess the morphological characteristics of carotid atherosclerotic plaque and the degree of carotid artery stenosis in patients with intracranial ischemic changes,and the MSCTA examination results of MSCTA can independently assess the risk of poor prognosis.