三维薄块多层重叠技术识别颈动脉粥样硬化斑块稳定性的临床研究

Clinical study of identifying the stability of atherosclerotic plaque in carotid with 3D MOTSA

目的 探讨采用三维 (3D)薄块多层重叠技术 (multipleoverlappingthinslabangiography,MOTSA)检查颈动脉粥样硬化斑块稳定性的影像学特征及不稳定性斑块与缺血性卒中的关系。方法 对 4 0例明确为颈内动脉系统缺血性卒中急性期病例 (A组 )和 2 5例明确在 3个月内无颈内动脉系统缺血性卒中病例 (B组 )的颈动脉进行 3DMOTSA检查 ,将发现的粥样斑块按纤维帽特征分型。结果 3DMOTSA检查发现 4 1例患者存在粥样斑块 ,纤维帽厚型、薄型及破裂型分别为 19、14、8例 ,A组4 5 %为不稳定斑块 (薄型和破裂型纤维帽 ) ,B组 16 %为不稳定斑块 ,两组比较差别有显著性 (P <0 0 1)。结论 3DMOTSA检查可识别颈动脉内覆盖在脂质核上的纤维帽 ,不稳定斑块脱落可能与近期缺血性卒中有关。

Objective To investigate the stability characteristic of atherosclerotic plaque in carotid with 3D MOTSA and the relationship between instability plaque and ischemic stroke.Methods The carotids of 65 cases were examined with 3D MOTSA,including 40 cases with acute systemic ischemic stroke of internal carotid(A group)and 29 cases without acute systemic ischemic stroke of internal carotid within recent 3 months (B group),and atheromatous plaque was classified by the characteristics of fibrous cap. Results The atheromatous plaque were found in 41 patients including 19 cases thick type,14 cases thin type and 8 cases rupture type. Forty-five percent of the patients had instability plaque(fibrous cap thin type and rupture type)in A group,but only sixteen percent of the patients had instability plaque in B group. There were significant difference between two groups (P<0.01).Conclusion 3D MOTSA could identify the fibrous cap on lipid nucleus .The shedding of instability plaque is likely to recent ischemic stroke.