CT血管造影检查急性脑梗死患者大脑中动脉粥样硬化斑块的特征及其临床意义

Characteristics and clinical significance of MCA atherosclerotic plaques detected via CTA in patients with acute cerebral infarction

目的探讨CT血管造影(CTA)检查急性脑梗死(ACI)患者大脑中动脉(MCA)粥样硬化斑块的特征及其临床意义。方法选取2019年8月—2022年8月无锡市第九人民医院收治的ACI患者102例作为ACI组,另取该院同期接受CTA检查发现MCA粥样硬化斑块形成的非ACI患者100例作为对照组。对比两组患者MCA狭窄程度、斑块类型特征,并按照ACI患者不同神经功能缺损程度对上述指标进行分层分析。结果ACI组患者检出软斑块104个(42.80%)、混合斑块81个(33.33%)、纤维斑块34个(13.99%)、钙化斑块24个(9.88%),对照组检出软斑块54个(24.88%)、混合斑块32个(14.75%)、纤维斑块71个(32.72%)、钙化斑块60个(27.65%),差异有统计学意义(P<0.05)。ACI组患者的MCA狭窄程度高于对照组(P<0.05)。NIHSS评分≥15分ACI患者检出软斑块43个(44.79%)、混合斑块40个(41.67%)、纤维斑块8个(8.33%)、钙化斑块5个(5.21%),NIHSS评分<15分ACI患者检出软斑块61个(41.50%)、混合斑块41个(27.89%)、纤维斑块26个(17.69%)、钙化斑块19个(12.93%),差异有统计学意义(P<0.05)。NIHSS评分≥15分ACI患者的MCA狭窄程度高于NIHSS评分<15分ACI患者(P<0.05)。结论ACI患者的MCA主要以混合型斑块、软斑块及中、重度狭窄为主,并且与ACI患者神经功能缺损程度关系密切。

Objective To investigate the characteristics and clinical significance of middle cerebral artery(MCA)atherosclerotic plaques in patients with acute cerebral infarction(ACI)as detected by computed tomography angiography(CTA).Methods The 102 patients with acute cerebral infarction(ACI)admitted to Wuxi Ninth People’s Hospital from August 2019 to August 2022 were selected as the ACI group,and 100 non-ACI patients with MCA atherosclerotic plaque formation in the hospital during the same period were selected as the control group.The degree of MCA stenosis and plaque characteristics of the two groups were compared,and they were stratified and further analyzed according to the severity of neurological impairment in ACI patients.Results A total of 104 cases of soft plaques(42.80%),81 mixed plaques(33.33%),34 fibrous plaques(13.99%),and 24 calcified plaques(9.88%)were detected in the ACI group,while there were 54 cases of soft plaques(24.88%),32 mixed plaques(14.75%),71 fibrous plaques(32.72%),and 60 calcified plaques(27.65%)in the control group,which were significantly different from those in the ACI group(P<0.05).The degree of MCA stenosis in the ACI group was higher than that in the control group(P<0.05).Among ACI patients with NIHSS scores no less than 15,there were 43 cases of soft plaques(44.79%),40 mixed plaques(41.67%),8 fibrous plaques(8.33%),and 5 calcified plaques(5.21%),whereas 61 cases of soft plaques(41.50%),41 mixed plaques(27.89%),26 fibrous plaques(17.69%)and 19 calcified plaques(12.93%)were detected in ACI patients with NIHSS scores less than 15.The compositions of the types of plaques were different among the two subgroups(P<0.05).The degree of MCA stenosis in ACI patients with NIHSS scores no less than 15 was higher than that in those with NIHSS scores less than 15(P<0.05).Conclusions The MCA plaques in ACI patients are mainly mixed and soft plaques with moderate to severe stenosis,and are closely related to the degree of neurological impairment in ACI patients.