CT血管成像评估中重度颈动脉狭窄患者斑块厚度及性质与急性脑血管事件的相关性

目的探讨颈动脉中重度狭窄患者颈部CT血管成像(computed tomography angiography,CTA)上不同斑块成分的厚度及性质与脑血管事件(脑梗死或短暂性脑缺血发作)的相关性。方法回顾性分析颈部CTA扫描的患者120例,根据有无脑血管事件分为症状组77例及无症状组43例。颅外颈动脉狭窄≥50%为中重度狭窄,分别测量CTA源图像斑块各成分的厚度及软斑内的CT值。同时用logistic回归分析法,分析颈动脉斑块特征与脑血管事件的相关程度。结果症状组患者软斑厚度明显大于无症状组(3.29±1.00)mmvs(2.51±0.80)mm],硬斑厚度明显小于无症状组(1.44±0.97)mmvs(1.94±0.75)mm,P<0.01]。logistic回归分析显示,软斑厚度与脑血管事件有很好相关性(OR=4.882,95%CI:1.914¹2.448,P=0.001)。结论颈动脉软斑厚度的增加与脑血管事件危险度密切相关,通过检测颈动脉软斑块的厚度,可以为预防颈动脉中重度狭窄患者脑血管意外的发生,提供简单、可靠的临床评估方法。

CTA in evaluating association of plaque thickness and nature with acute cerebrovascular events in moderate-severe carotid stenosis

Objective To study the association of plaque thickness and nature with cerebrovascular events in moderate-sever carotid stenosis patients.Methods One hundred and twenty patients who underwent neck CT angiography were divided into symptomatic group(n=77)and asymptomatic group(n=43)according to whether they had cerebrovascular events.Extracranial carotid stenosis≥50% was defined as moderate-severe stenosis.Plaque thickness and CT value in soft plaques were measured.Association between carotid plaque nature and cerebrovascular events was analyzed by logistic regression analysis.Results The soft plaques were significantly thicker while the hard plaques were significantly thinner in symptomatic group than in asymptomatic group(3.29±1.00 mmvs 2.51±0.80 mm,1.44±0.97mmvs1.94±0.75 mm,P<0.01).Logistic regression analysis showed that the thickness of soft plaques was closely related with the incidence of cardiovascular events(OR=4.882,95%CI:1.914-12.448,P=0.001).Conclusion Thicker soft plaques are closely related with cardiovascular risks.Detecting carotid soft plaque thickness is a simple and reliable method to assess the occurrence of cerebrovascular accidents in moderatesevere carotid artery stenosis patients.