超声和多层螺旋CT血管造影检测脑梗死患者颅外颈

发布时间：2018-11-17 11:04

【摘要】：研究背景脑梗死是威胁人类生命安全的三大杀手之一,其中三分之二的病例是动脉硬化所致。颈动脉硬化导致的颈动脉狭窄是缺血性脑血管疾病的一个重要危险因素。有些狭窄性病变甚至可能逐渐发展至完全闭塞。由此可见,对颈动脉粥样斑块的准确诊断和处理至关重要。准确评估狭窄范围、精确测量狭窄的程度和识别斑块的形态、特征,是决定是否需要手术及选择手术方式的关键。超声(US)已被证明是一种良好的筛选颈动脉斑块的技术。它可以显示血管走形、管腔内径、管壁内-中膜厚度(IMT)及血管内有无斑块形成等。利用多普勒超声还可获得血流动力学信息。多层螺旋CT血管造影(MSCTA)目前已广泛应用于颈动脉的研究中。它可以清晰显示斑块性质和确定狭窄程度。它可提供更多的病变细节和解剖信息,极大方便了临床医生对病变的评价和治疗。目的比较超声和MSCTA对脑梗死患者颈动脉斑块的检查一致性及对斑块定位、定性、狭窄程度判定的临床价值。方法对65例脑梗死患者在一周内进行超声和MSCTA检查,分别观察斑块有无、位置、性质及血管狭窄程度,并对其进行统计学分析。结果65例脑梗死患者经超声和MSCTA检查分别发现了42例、43例患者颅外颈动脉斑块,两者对于颈动脉粥样硬化斑块的检出率差异无统计学意义,一致性约79%。超声检查还可以观测颈动脉内-中膜厚度及血流动力学改变。MSCTA除可检测颅外颈动脉颈段外,还可检测颈动脉岩骨段、海绵窦段及颅内段等。结论颈动脉粥样硬化和脑梗死的关系密切。超声和MSCTA在对动脉粥样硬化的检查中具有互补作用。
[Abstract]:Background Cerebral infarction is one of the three major killers threatening human life. 2/3 of the cases are caused by arteriosclerosis. Carotid stenosis due to carotid atherosclerosis is an important risk factor for ischemic cerebrovascular disease. Some narrow lesions may even gradually develop to complete occlusion. Therefore, it is very important for the accurate diagnosis and management of carotid atherosclerotic plaque. Accurately evaluating the extent of stenosis, accurately measuring the extent of stenosis and identifying the shape and characteristics of plaque are the key to determine whether surgery is necessary and how to choose surgical methods. Ultrasound (US) has proved to be a good technique for carotid plaque screening. It can show the shape of the vessel, the diameter of the lumen, the intramural thickness of (IMT) and the formation of plaque in the vessel. Hemodynamic information can also be obtained by Doppler ultrasound. Multislice spiral CT angiography (MSCTA) has been widely used in the study of carotid artery. It can clearly show the nature of plaque and determine the degree of stenosis. It can provide more details and anatomical information, and greatly facilitate clinicians to evaluate and treat the lesions. Objective to compare the consistency of ultrasonography and MSCTA in the diagnosis of carotid plaque in patients with cerebral infarction, and to evaluate the clinical value of plaque localization, qualitative analysis and degree of stenosis. Methods 65 patients with cerebral infarction were examined by ultrasound and MSCTA within one week. Results Forty-two patients and 43 patients with extracranial carotid artery plaque were found by ultrasound and MSCTA in 65 patients with cerebral infarction. There was no significant difference in the detection rate of carotid atherosclerotic plaque between the two groups, and the consistency was about 79%. MSCTA not only could detect the carotid artery, but also the petrosal bone segment, cavernous sinus segment and intracranial segment of the carotid artery, so that MSCTA could also detect the carotid artery intima-media thickness and hemodynamic changes of the carotid artery, such as the extracranial carotid artery, the petrosal bone segment, the cavernous sinus segment and the intracranial segment. Conclusion carotid atherosclerosis is closely related to cerebral infarction. Ultrasound and MSCTA play complementary roles in the detection of atherosclerosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R743.3;R816.1

【参考文献】