缺血性脑血管病患者颈动脉粥样硬化斑块分析

目的探讨多排螺旋CT血管造影对颈动脉粥样硬化斑块形态、性质的分析。方法回顾性分析中国中医科学院西苑医院2011年1～10月223例脑血管病患者的CT血管造影资料，其中脑梗死组134例，无脑梗死组65例。采用256层螺旋CT分析颈动脉粥样硬化斑块的形态、性质。结果脑梗死组发现斑块267个，其中脂肪、纤维及钙化斑块分别占56．9％、22．5％和20．6％；无脑梗死组发现斑块86个，其中脂肪、纤维及钙化斑块分别占26．7％、20．9％和52-3％；三类斑块在两组中的分布差异有统计学意义（P〈0．01）。脑梗死组及无脑梗死组溃疡斑块分别为14．9％和4．6％，溃疡斑块在两组中分布差异有统计学意义（P〈0．05）。在脑梗死组中，脂肪、纤维及钙化斑块出现中度以上血管狭窄比例分别为48．7％、18.3％和7.3％，中度以上血管狭窄在三组斑块中的分布差异有统计学意义（P〈0．01）。结论多排螺旋CT能够评价颈动脉斑块形态、性质，脂肪斑块、斑块溃疡具有不稳定性，易引起缺血性脑血管病。

Analysis of the carotid atherosclerotic plaque in patiens with ischemic cerebrovascular disease

Objective To expore the mOrphology and Characteristics of carotid atherosclerotic plaque by multi-slice spiral CT. Methods 223 patients with ischemic cerebrovascular disease detected by CT angiography in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to October in 2011 were analyzed retrospectively. Patients were divided into cerebral infarction group （134 cases） and no cerebral infarction group （65 cases）. The component and character of carotid atherosclerotic plaque was detected by 256 slices computed tomography （CT）. Results 267 plaques were detected in cerebral infarction group, of which, the incidences of fatty plaque, fibrous plaque and calcified plaque were 56.9%, 22.5% and 20.6% respectively. 86 plaques were detected in no cerebral infarction group, of which, the incidences of fatty plaque, fibrous plaque and calcified plaque were 26.7%, 20.9% and 52.3% respectively （P 〈 0.01）. The proportion of ulceration plaque was 14.9% and 4.6% respectively in cerebral infarction group and no cerebral infarction group （P 〈 0.01）. The proportion of fatty plaque, fibrous plaque and calcified plaque with moderate stenosis was 48.7%, 18.3% and 7.3% respectively in cerebral infarction group （P 〈 0.01）. Conclusion The morphology and characteristics of carotid atheroselerotic plaque can be evaluated by muhislice spiral CT. The fatty plaque and ulceration plaque are unstable, which result in ischemic cerebrovascular disease easily.