64层螺旋CTA评估颈动脉粥样硬化斑块内出血的应用价值

发布时间：2018-06-27 17:33

  本文选题：斑块内出血 + 颈动脉狭窄　； 参考：《中国老年学杂志》2017年15期

【摘要】：目的探索64层螺旋CTA评估颈动脉斑块内出血的应用价值。方法选择2014年9月至2015年6月于大连医科大学附属第二医院神经内科住院患者为研究对象,将经颈部血管彩超发现单侧或双侧颈动脉狭窄50%~99%的患者纳入本研究,对所有纳入研究的患者完成颈动脉MRI及CTA检查,并根据MRI检查结果将其分为斑块内出血(IPH)组和非IPH组,比较两组CTA影像学特点(包括斑块内CT值以及是否存在斑块溃疡)的差异性。结果单侧或双侧颈动脉狭窄50%~99%的患者97例,狭窄颈动脉共114条,其中存在IPH者67例,IPH的发生率约为58.8%。CTA检查结果示IPH组斑块内平均CT值为(87.13±14.82)HU,非IPH组为(35.17±12.47)HU,两组比较存在统计学差异(P0.05)。CTA检查结果示IPH组存在斑块溃疡者53例(79.1%),非IPH组5例(10.6%);CTA评估斑块溃疡的敏感性为79.1%,特异性为89.4%,阳性预测值为91.4%,阴性预测值为75%,两组在是否存在斑块溃疡方面存在统计学差异(P0.05)。结论对于存在MRI检查禁忌的患者,可使用CTA对颈动脉斑块进行评估,以斑块内CT值以及斑块溃疡作为评价指标,从而更好地指导下一步治疗。
[Abstract]:Objective to explore the value of 64-slice spiral CTA in the evaluation of carotid plaque hemorrhage. Methods patients in Department of Neurology, second affiliated Hospital of Dalian Medical University from September 2014 to June 2015 were selected as subjects. 50% or 99% of patients with unilateral or bilateral carotid artery stenosis were detected by color Doppler sonography. Carotid MRI and CTA were performed in all patients who were included in the study, and were divided into plaque hemorrhage (IPH) group and non-IPH group according to MRI findings. The imaging features of CTA (including intraplaque CT value and plaque ulcer) were compared between the two groups. Results 97 cases of unilateral or bilateral carotid artery stenosis were 50% and 99%, with 114 carotid artery stenosis. The incidence of IPH in 67 cases with IPH was about 58.8%. The results of CTA showed that the average CT value of plaque in IPH group was (87.13 卤14.82) HUU, and that in non-IPH group was (35.17 卤12.47) HU.There was statistical difference between the two groups (P0.05) .CTA showed that 53 cases (79.1%) had plaque ulcer in IPH group and 55.1% in non-IPH group. The sensitivity, specificity, positive predictive value and negative predictive value of CTA for plaque ulcer were 79.1, 89.4, 91.4 and 75, respectively (P0.05). Conclusion CTA can be used to evaluate carotid plaques in patients with contraindication of MRI examination. Ct value of plaque and plaque ulcer can be used as evaluation index, so as to better guide the next treatment.
【作者单位】： 大连医科大学附属第二医院神经内3科;
【基金】：辽宁省科技厅社发攻关及成果产业化项目(2013225002)
【分类号】：R743.3;R816.1
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本文编号：2074685