256排CTA在颈部动脉夹层诊断及介入治疗中的应用

发布时间：2018-04-18 09:52

本文选题：颈部动脉夹层 + 256排CTA　；参考：《复旦大学》2012年硕士论文

【摘要】：[研究背景及目的]：颈部动脉夹层是青年及中年人脑卒中的重要原因,其临床表现多变。传统的数字减影血管造影(digital subtraction angiography,DSA)一直被认为是诊断颈部动脉夹层的金标准,近年来CT血管造影检查临床上越来越多用于非侵入性的替代检查方法。本研究的目的在于对比256排CT血管造影(CT angiography,CTA)和DSA、MR T1脂肪抑制加权序列(MRT1-weighted fat-suppressed, MRT1-FS)诊断颈部动脉夹层常见影像学征象的敏感性。 [材料及方法]：采用回顾性分析方法,收集自2010年2月至2012年3月复旦大学附属华山医院放射介入及神经内科收治经DSA或M R T1-FS确诊为颈部动脉夹层的连续患者。回顾性分析其256排CTA的影像学征象,包括血管狭窄、内膜瓣、双腔征、血管闭塞、管壁增厚(内膜血肿)以及夹层动脉瘤形成等。 [结果]：本研究包合58例连续病人(男性40例,平均年龄46.9±11.9岁),共68处动脉夹层病变(前循环29例,后循环39例)。与DSA相比CTA可以显示85%的内膜瓣(22/26),67%的双腔征(4/6),CTA显示血管狭窄有很高的敏感性94%(33/35)。显示夹层动脉瘤及血管闭塞两者无差别。相比MR T1-FS,256排CTA亦可以很好的显示血管内膜增厚。 [总结]：本研究正式256排CTA可以清晰显示包括血管腔及管壁在内颈部动脉夹层的多种影像学征象,是诊断颈部动脉夹层快速而有效的影像学方法,对指导临床选择合适的介入治疗方法有重要意义。
[Abstract]:Background and objective: carotid artery dissection is an important cause of stroke in young and middle aged people.Traditional digital subtraction angiography has been regarded as the gold standard for the diagnosis of cervical artery dissection. In recent years, CT angiography has been more and more used in non-invasive alternative examination.The purpose of this study was to compare the sensitivity of 256 slice CT angiography (CTAA) and DSA-Mr T1 fat suppression weighted sequence (MRT1-weighted fat-suppressed MRT1-FS) in the diagnosis of common imaging signs of cervical artery dissection.Materials and methods: from February 2010 to March 2012, consecutive patients with cervical artery dissection diagnosed by DSA or M R T1-FS were collected from Huashan Hospital affiliated to Fudan University.The imaging features of 256-row CTA were retrospectively analyzed, including vascular stenosis, intimal flap, double lumen sign, vascular occlusion, wall thickening (intimal hematoma) and dissecting aneurysm.[results]: this study included 58 consecutive patients (male 40, mean age 46.9 卤11.9 years old). There were 68 dissecting lesions (anterior circulation in 29 cases and posterior circulation in 39 cases).Compared with DSA, CTA can display 85% of intimal flap 22 / 26 / 67% of double lumen sign 4 / 6 / 6 / CTA with a high sensitivity of 9433 / 35 / 35.There was no difference between dissecting aneurysm and vascular occlusion.Compared with Mr T 1-FSU 256 row CTA, intima thickening can also be well demonstrated.[summary]: in this study, 256-row CTA can clearly display various imaging signs of internal cervical artery dissection, including vascular lumen and wall, which is a rapid and effective imaging method for the diagnosis of cervical artery dissection.It is of great significance to guide clinical choice of appropriate interventional therapy.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.1

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