脑梗死患者颈动脉斑块稳定性应用超声联合螺旋CT的评估效果

Evaluation of carotid plaque stability in patients with cerebral infarction by ultrasound combined with spiral CT

目的 探讨应用超声联合螺旋CT评估脑梗死患者颈动脉斑块稳定性的效果。方法 选取2019年6月至2020年12月本院神经内科收治的150例脑梗死患者作为研究对象,患者均接受彩色多普勒血流显像(CDFI)与多层螺旋CT血管成像(MSCTA)检查,比较两种方式检测颈动脉分叉病变情况、斑块检出情况及患者颈动脉狭窄发生情况。结果 MSCTA与CDFI对脑梗死患者颈动脉斑块稳定性的评估分别为82.60%、80.43%,差异无统计学意义;CDFI单纯低回声软斑检出率为17.40%,钙化检出率为29.34%;MSCTA单纯低回声软斑检出率为14.40%,钙化检出率为38.86%,钙化的区别,MSCTA敏感度为100.00%(108/108),特异度为67.83%(97/143);CDFI、MSCTA在管腔狭窄程度中的评估效果与脑血管造影(DAS)比较差异无统计学意义。结论 应用超声联合螺旋CT评估脑梗死患者颈动脉斑块稳定性效果显著,且二者一致性高,在临床中可首先选择CDFI进行检测,经CDFI检查存在血管病变风险者再进行MSCTA检查,以确定脑梗死患者的颈动脉斑块稳定性。

Objective To investigate the effect of ultrasound combined with spiral CT in evaluating the stability of carotid plaque in patients with cerebral infarction. Methods 150 patients with cerebral infarction treated in the Department of Neurology of our hospital from June 2019 to December 2020 were selected as the research subjects, all patients underwent color Doppler flow imaging(CDFI) and multi-slice spiral CT angiography(MSCTA). The detection of carotid bifurcation lesions, plaque detection and the occurrence of carotid stenosis were compared between the two methods. Results MSCTA and CDFI evaluated the stability of carotid plaque in patients with cerebral infarction, which were 82.60% and 80.43% respectively;the detection rate of simple hypoechoic soft spot and calcification on CDFI was 17.40% and 29.34%, respectively;the detection rate of simple hypoechoic soft spot and calcification by MSCTA was 14.40% and 38.86%, respectively. The sensitivity and specificity of MSCTA were 100.00%(108/108) and 67.83%(97/143);there was no significant difference in the evaluation effect of CDFI and MSCTA in the degree of lumen stenosis compared with digital subtraction angiography(DAS). Conclusion Ultrasound combined with spiral CT is effective in evaluating the stability of carotid plaque in patients with cerebral infarction, and the consistency between them is high. In clinical practice, CDFI can be selected for detection first, and MSCTA can be performed for those at risk of vascular disease after CDFI, so as to determine the stability of carotid plaque in patients with cerebral infarction.