Physiologic imaging in acute stroke: Patient selection

Treatment of acute stroke is changing, as endovascular intervention becomes an important adjunct to tissue plasminogen activator. An increasing number of sophisticated physiologic imaging techniques have unique advantages and applications in the evaluation, diagnosis, and treatment-decision making of acute ischemic stroke. In this review, we first highlight the strengths, weaknesses, and possible indications for various stroke imaging techniques. How acute imaging findings in each modality have been used to predict functional outcome is discussed. Furthermore, there is an increasing emphasis on using these state-of-the-art imaging modalities to offer maximal patient benefit through IV therapy, endovascular thrombolytics, and clot retrieval. We review the burgeoning literature in the determination of stroke treatment based on acute, physiologic imaging findings.     

The role of neuroimaging in children and adolescents with recurrent headaches--multicenter study

Objectives.— To evaluate the role of neuroimaging and to estimate the prevalence of significant and treatable intracranial lesions in children and adolescents with recurrent headaches. Background.— Neuroimaging studies are commonly performed in children and adolescent patients with headache because of increasing demands by parents and physicians, although objective data and studies to support this widespread practice are minimal. Methods.— We retrospectively reviewed the medical records of all 1562 (male 724, female 838) new patients presenting with recurrent headaches to 9 Pediatric Neurology Clinics of tertiary Hospitals. Data regarding age of onset, duration of symptoms before presentation, frequency, duration of each episode, intensity, location and quality of headache, associated neurologic symptoms and a comprehensive neurological examination were obtained for each patient. The International Classification of Headache Disorders, second edition, was used to classify headache types. Results.— Neuroimaging procedures were performed in 77.1% of the patients. Overall, 9.3% (112/1204) of the patients had abnormal findings from neuroimaging. The highest yield was in patients with an abnormal neurological examination wherein abnormal findings on neuroimaging were seen in 50.0% (9/18) of patients (P < .001). The yield was low when imaging was carried out in view of changes in the type of headache (12.9% [26/201]), neurologic dysfunction (10.8% [9/83]), recent onset of severe headaches (7.0% [12/171]), and demands of parent and physicians (10.1% [21/208]). Eleven patients underwent surgery based on neuroimaging results. There was no significant relation between abnormality on neuroimaging and age, sex, headache type, age of onset of headache, duration of symptoms before presentation, duration, frequency, location and intensity of headache (P > .05). Conclusions.— Neuroimaging procedures in children and adolescents with headaches, although not always required, are very commonly performed. We suggest that more strict guidelines for rational use of neuroimaging are needed for pediatric headache patients.     

网络游戏成瘾的认知功能和神经影像学研究进展

互联网科技快速发展之下,网络游戏成瘾（IGD）已经成为全球性心理健康问题。目前大多数关于IGD的研究主要集中在奖赏系统、抑制控制及跨期决策3个方面。随着认知神经科学的发展,采用脑电图（EEG）、MRI和PET等技术探讨IGD的神经机制已成为主流。与健康对照者相比,IGD者脑结构和功能均发生相应变化,且大脑损害程度与成瘾行为的持续时间有关。本文对近年来有关IGD的认知功能及其神经影像学研究进展进行综述,重点介绍其研究方法和相应结果,为进一步探索该领域及相关研究拓展思路。     

缺血性脑卒中的神经影像学进展

当一个人不幸中风时,必须明确发病机制、病理生理学改变以及评估中风的恢复潜力.临床技术进步让卒中的多个阶段,包括预防、急性中风和中风后恢复,都得到了更好的监测和治疗.神经影像学技术的飞速发展可量化组织功能和评估预后,从而分类患者以进行预防性和个性化治疗.本综述将重点陈述目前评估缺血性卒中的高级磁共振技术,如磁共振扩散谱成...     

Application of MAGnetic resonance imaging compilation in acute ischemic stroke

BACKGROUNDSynthetic magnetic resonance imaging (MRI) MAGnetic resonance imaging compilation (MAGiC) is a new MRI technology. Conventional T1, T2, T2-fluid-attenuated inversion recovery (FLAIR) contrast images, quantitative images of T1 and T2 mapping, and MAGiC phase sensitive inversion recovery (PSIR) Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a scan. In recent years, studies have reported that MAGiC can be applied to patients with acute ischemic stroke. We hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic stroke.AIMTo explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic stroke.METHODSA total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort study. The scanning sequences included traditional T1, T2, and T2-FLAIR, three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA), diffusion-weighted imaging (DWI), and synthetic MRI. Conventional contrast images (T1, T2, and T2-FLAIR) and intracranial vessel images (MAGiC PSIR Vessel] were automatically reconstructed using synthetic MRI raw data. The contrast-to-noise ratio (CNR) values of traditional T1, T2, and T2-FLAIR images and MAGiC reconstructed T1, T2, and T2-FLAIR images in DWI diffusion restriction areas were measured and compared. MAGiC PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis areas. The consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography (CTA) was compared.RESULTSAmong the 64 patients with acute ischemic stroke, 79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA (r = 0.90, P < 0.01) was higher than that between TOF MRA and CTA (r = 0.84, P < 0.01). With a degree of vascular stenosis > 50% assessed by CTA as a reference, the area under the receiver operating characteristic (ROC) curve of MAGiC PSIR Vessel [area under the curve (AUC) = 0.906, P < 0.01] was higher than that of TOF MRA (AUC = 0.790, P < 0.01). Among the 64 patients with acute ischemic stroke, 39 were scanned for traditional T1, T2, and T2-FLAIR images and MAGiC images simultaneously, and CNR values in DWI diffusion restriction areas were measured, which were: Traditional T2 = 21.2, traditional T1 = -6.7, and traditional T2-FLAIR = 11.9; and MAGiC T2 = 7.1, MAGiC T1 = -3.9, and MAGiC T2-FLAIR = 4.5.CONCLUSIONThe synthetic MRI vascular screening scheme for patients with acute ischemic stroke can accurately evaluate the degree of bilateral middle cerebral artery stenosis, which is of great significance to early thrombolytic interventional therapy and improving patients’ quality of life.     

The micro-architecture of the cerebral cortex: functional neuroimaging models and metabolism

In order to interpret/integrate data obtained with different functional neuroimaging modalities (e.g. fMRI, EEG/MEG, PET/SPECT, fNIRS), forward-generative models of a diversity of brain mechanisms at the mesoscopic level are considered necessary. For the cerebral cortex, the brain structure with possibly the most relevance for functional neuroimaging, a variety of such biophysical models has been proposed over the last decade. The development of technological tools to investigate in vitro the physiological, anatomical and biochemical principles at the microscopic scale in comparative studies formed the basis for such theoretical progresses. However, with the most recent introduction of systems to record electrical (e.g. miniaturized probes chronically/acutely implantable in the brain), optical (e.g. two-photon laser scanning microscopy) and atomic nuclear spectral (e.g. nuclear magnetic resonance spectroscopy) signals using living laboratory animals, the field is receiving even greater attention. Major advances have been achieved by combining such sophisticated recording systems with new experimental strategies (e.g. transgenic/knock-out animals, high resolution stereotaxic manipulation systems for probe-guidance and cellular-scale chemical-delivery). Theoreticians may now be encouraged to re-consider previously formulated mesoscopic level models in order to incorporate important findings recently made at the microscopic scale. In this series of reviews, we summarize the background at the microscopic scale, which we suggest will constitute the foundations for upcoming representations at the mesoscopic level. In this first part, we focus our attention on the nerve ending particles in order to summarize basic principles and mechanisms underlying cellular metabolism in the cerebral cortex. It will be followed by two parts highlighting major features in its organization/working-principles to regulate both cerebral blood circulation and neuronal activity, respectively. Contemporary theoretical models for functional neuroimaging will be revised in the fourth part, with particular emphasis in their applications, advantages/limitations and future prospects.     

烟雾病颅脑磁共振影像学诊断特征分析

目的探讨烟雾病患者颅脑磁共振成像(MRI)平扫及磁共振血管造影(MRA)影像学特点。 方法回顾性分析2014年10月至2019年3月丰县人民医院神经内外科及儿科收治的资料完整的25例烟雾病患者的临床及影像学资料。所有患者均行常规1.5T轴位T1WI、T2WI、液体衰减反转恢复(FLAIR)、弥散加权(DWI)及矢状位T2WI序列扫描，同时行三维—时间飞跃(3D-TOF)法MRA扫描；病程中患者均有CT平扫资料，15例有CT血管造影(CTA)资料，12例有数字减影血管造影(DSA)资料。 结果MRI平扫均可显示双侧颈内动脉末端、大脑中动脉及大脑前动脉变细、流空差，颅底中线两旁区域出现烟雾状流空信号影，以轴位T2WI显示最佳；FLAIR见两侧大脑半球沿软脑膜分布的点状或条状高信号("常春藤征")，以额顶叶为多；21例患者的T2WI及FLAIR还可见放射冠、半卵圆中心白质区呈现垂直于侧脑室壁的刷子状高信号("刷子征")，20例T2WI可见基底节区血管流空信号影。MRI诊断25例脑梗死(伴新鲜梗死灶6例)，陈旧性出血9例。MRA可显示双侧颈内动脉末端、大脑中动脉及大脑前动脉不同程度狭窄或闭塞、颅底异常血管网形成，TOF源图像均可见两侧基底节区高信号强度区域。 结论MRI及MRA可显示烟雾病特征性的血管狭窄、侧支循环征象及所造成的卒中等不良结果，值得应用。     

Thresholding of statistical maps in functional neuroimaging using the false discovery rate

Finding objective and effective thresholds for voxelwise statistics derived from neuroimaging data has been a long-standing problem. With at least one test performed for every voxel in an image, some correction of the thresholds is needed to control the error rates, but standard procedures for multiple hypothesis testing (e.g., Bonferroni) tend to not be sensitive enough to be useful in this context. This paper introduces to the neuroscience literature statistical procedures for controlling the false discovery rate (FDR). Recent theoretical work in statistics suggests that FDR-controlling procedures will be effective for the analysis of neuroimaging data. These procedures operate simultaneously on all voxelwise test statistics to determine which tests should be considered statistically significant. The innovation of the procedures is that they control the expected proportion of the rejected hypotheses that are falsely rejected. We demonstrate this approach using both simulations and functional magnetic resonance imaging data from two simple experiments.     

乳腺癌化疗相关认知损害神经影像标志物的研究进展

神经影像技术特别是MRI在评估脑解剖结构及功能变化等方面应用广泛,已逐渐成为临床研究乳腺癌化疗相关认知损害(chemotherapy-related cognitive impairment,CRCI)的有力工具,并为其早期诊断提供了客观的影像诊断标志物。本文就神经影像方法在乳腺癌CRCI神经影像标志物研究中的应用进展进行文献综述,以期为揭示其病理生理机制及早期诊断研究提供影像学依据。     

Color Doppler of the extracranial and intracranial arteries in the acute phase of cerebral ischemia

Vascular imaging greatly improves the possibility of locating the site of vascular occlusion in patients with acute cerebrovascular disease. Different occlusive patterns may underlie the same clinical presentation, with different prognosis and different treatment: for this reason, a diagnostic tool able to identify quickly the status of the extra- and intracranial vessels is needed. Color Doppler ultrasound of the extracranial arteries is a reliable and accurate method able to localize and quantify the carotid artery stenosis. The ultrasound quantification of the degree of stenosis is based on both morphological and velocimetric criteria: B-mode, color or power Doppler and spectral analysis are used for this purpose. Also the analysis of the plaque is an integral part of the ultrasound examination: the B mode plaque characterization (structure and surface) plays an important role in the evaluation of risk of stroke. So color Doppler ultrasound is able to select patients who may require medical therapy, carotid endarterectomy or angioplasty and stenting. Transcranial color Doppler is an inexpensive, reliable, fast, non-invasive, bedside tool: in the acute phase of stroke, it is able to evaluate quickly the intracranial arteries and monitor the possible recanalization of occluded vessel ensuring the follow-up of dynamic lesions, such as the intracranial stenosis and occlusions.     

组织谐波成像在急性心肌梗死诊断中的应用--与冠状动脉造影对照研究

目的 探讨组织谐波成像(THI)技术在急性心肌梗死诊断中的应用价值。方法 分析经THI及冠状动脉造影检查的101例急性心肌梗死患者的临床资料。结果 图像满意和较满意率达96．0％。THI对急性心肌梗死检出率为91．1％。THI与心电图估测心肌梗死部位及范围基本一致。THI估测心肌梗死部位与冠状动脉造影所示梗死相关动脉供血区域基本相符(准确率87．1％)，其中以检出左前降支病变所致心肌梗死的准确率最高(96．8％)；下壁、后壁或右室梗死常合并其他部位心肌梗死，较易漏诊。结论 THI是检测急性心肌梗死敏感而准确的方法，可与心电图相互印证、相互补充。检查中应特别注意有无合并下壁、后壁或右室梗死，以免漏诊。     

Twenty-five years of clinical chemistry 1964-1989. Challenges, progress and pitfalls

The 25th anniversary of the founding of the German Society for Clinical Chemistry is cause for reflection on the scientific development of clinical chemistry as a discipline within the field of medicine. It also provides an opportunity to review the aims of the Society's activities over the next decade, and to present some ideas for consideration. The founding of the German Society for Clinical Chemistry and the situation that led up to it is discussed. Challenges confronting laboratory directors at the time of the founding of the Society are described, and the chronological and logical development of the three pillars of clinical chemistry out of these challenges is outlined: general clinical chemistry, analytical chemistry in the biological matrix, clinical or pathological biochemistry. Finally, the mistakes of the last 25 years and continuing dangers are critically addressed, and the good prospects of meeting the challenges that lie ahead are discussed.     

Functional imaging of subcortical nociceptive structures in response to treatment of chronic daily headache

Abstract The objective was to provide objective imaging evidence of functional changes in brainstem structures involved in chronic daily headache (CDH). Over time, episodic migraine (EM) patients may develop CDH known as transformed migraine (TM). Using analysis of transverse relaxation rates, R2, R2* and R2 (R2* values are reflective of blood oxygen level dependence; R2 is a measure of non-heme iron in tissues) we have reported activation (hyperoxia) of red nucleus (RN) and substantia nigra (SN) (decreased R2* and R2) in CDH patients studied during headache, and dysfunction of periaqueductal grey (PAG) based on increased iron levels (elevated R2) [1]. We now report a patient with CDH who, upon treatment, reverted to EM, permitting studies when headache free and an objective analysis of treatment response. SP is a female aged 48 years. She presented with daily headaches for 6 months. Episodic headaches, meeting IHS criteria for migraine without aura, began in her 20s. At the time of presentation she was taking 5 tablets of ergotamine tartarate in the form of Ercaf and 6 extra-strength acetaminophen daily. Repeated dosages of intravenous dihydroergotamine for three days during withdrawal of all medications successfully achieved clinical reversion from CDH to EM. She was studied both during CDH and when headache free after reverting to EM, using high-resolution MR techniques to map the transverse relaxation rates R2, R2* and R2 in RN, SN and PAG. For technical reasons, PAG was not imaged during the CDH phase of her illness. During the CDH phase of her illness, respective R2* values were reduced compared to normal in the RN and SN to 30.1 m/s and 31.45 m/s. Similarly, R2 in RN and SN were abnormally low at 6.62 m/s and 6.72 m/s compared to normal. Subsequent headache free studies demonstrated that R2* and R2 in the RN became 40.1 m/s and 15.47 m/s respectively, and in the SN, 40.25 m/s and 15.19 m/s respectively. These values were similar to EM patients and normal controls. The R2 in PAG during EM for this subject was increased at 6.88 m/s but elevated compared to controls. Daily headache in this patient was associated with chronic activation of pain networks that included RN and SN. Resolution of headache was associated with resolution of activation, although there was evidence for persistent PAG dysfunction, as previously reported. To the best of our knowledge, this case represents the first objective correlation of functional changes in brainstem nociceptive networks with clinical features of TM and its response to treatment.     

Depression in acute stroke: prevalence,dominant symptoms and associated factors. A systematic literature review

Purpose.?The aim of this review was to provide a comprehensive analysis of the state of knowledge about post-stroke depression (PSD) in the acute phase, focusing on: (a) the prevalence of depressive disorder and depressive symptoms, (b) the dominant depressive symptoms, (c) the factors associated with PSD and (d) the follow-up consequences.

Method.?A computer-aided search in MEDLINE, CINAHL, PsychInfo, EMBASE, British Nursing index, Pub Med and Ovid Nursing Database was performed. We systematically searched for studies including depression within the first month after stroke.

Results.?Forty articles including more than 5400 informants from 37 cohorts met the inclusion criteria. Only a few studies aimed to describe the nature of PSD. The prevalence of depressive disorder and depressive symptoms in the acute phase ranged widely from 5% to 54%. Multiple tools were used for measuring depressive symptoms in the acute phase. An association was found between early depressive symptoms and the continuation of PSD 12 months after stroke. There is a correlation between depressive symptoms and mortality at 12 and 24 months.

Conclusion.?Depressive symptoms are common in the acute phase after stroke and associated with persistency of depression and mortality after 12 months. A gold standard for the measurement of depressive symptoms in relation to stroke is missing. The knowledge of PSD in the acute phase is still limited, and there is a need for continued empirical research on its profile and patterns.     

3.0TMR全肝动脉期多时相增强扫描技术的初步应用

目的探讨全肝动脉期多时相三维动态增强MR扫描对肝脏动、门脉系统的显示情况及其在肝脏早期强化小病灶诊断中的初步应用。方法10例有肝脏动脉期强化小病灶(直径3cm以下)的患者纳入本次研究,使用3.0T磁共振扫描仪,动脉期多时相(4期)扫描作为全肝多期三维动态增强扫描的一部分,于一次屏气下完成。绘制主动脉、门静脉及肝实性病灶的时间信号强度曲线,并采用三维最大强度投影(MIP)重建肝动脉及门静脉,记录肝动脉的显示情况并分析病灶的强化特点。结果10例患者均获得了可用于诊断的高质量图像,共发现22个动脉期强化的小病灶。采用MIP重建,4例清晰显示肝固有动脉的3级分支,4例显示4级分支,2例显示5级分支,并能显示伴行的门静脉及早期强化的小病灶。不同类型的病灶强化特点不同。结论全肝动脉期多时相三维动态增强MR扫描可同时进行肝实质动态增强MRI和MR肝血管成像,能清晰显示肝脏早期强化小病灶的动态强化过程及其与周围血管的关系。     

MRI 指导下对轻症和症状迅速缓解患者的溶栓治疗

目的了解在MRI指导下对轻症和症状迅速缓解的急性脑梗死患者行静脉溶栓治疗的安全性和有效性。方法2010年4月至2012年5月,在MRI指导下对我院轻症和症状迅速缓解的急性脑梗死患者进行静脉溶栓治疗。观察并记录溶栓患者的基线临床特征、影像学表现、90 d时的临床转归,并将其与我院同期NIHSS＞4分溶栓患者及国外公开发表的同类研究结果进行比较。结果本组共计23例轻症和症状迅速缓解的急性脑梗死患者进行了静脉溶栓治疗,占同期溶栓患者总数的21.3％（23/108）。患者中存在大动脉严重狭窄或闭塞者8例（35％）,其中5例伴有灌注损害;幕下病变者6例（26％）。溶栓后90 d时结局为可独立行动（改良Rankin评分0～2分）患者21例（91％）、非症状性颅内出血1例（4.4％）,无死亡病例,明显优于本院同期 NIHSS ＞4分溶栓患者的结局（ P ＜0.01）。与国外其他同类研究的临床结局相近。结论在MRI指导下对轻症和症状迅速缓解脑梗死患者进行静脉溶栓治疗是安全、有效的。     

磁敏感加权成像与TOF-MR血管成像对急性脑梗死中大脑中动脉内血栓检测的对比研究

目的：比较研究磁敏感加权成像与TOF-血管成像(MRA)两种方法对检查急性脑梗死中大脑中动脉主要血管段内急性血管闭塞的诊断准确性。材料与方法61例大脑中动脉供血区急性脑梗死患者均行常规磁共振(MRI)和DWl、SWI、TOF-MRA检查。对SWI检测到的磁敏感血管征象(SVS)与MRA检测的大脑中动脉主要血管段不同程度狭窄或闭塞频率通过McNemar检验进行比较。结果61例脑梗死病变在DW I图像上均显示高信号,47例患者的患侧大脑深髓静脉较对侧明显扩张。59例患者在SWI上明确清晰显示SVS,其中有56例患者的SVS与MRA显示的闭塞或狭窄位置相匹配。两种技术在检测M1段内血栓性闭塞的灵敏度没有明显差异(SWI：98.1%;MRA：98.1%),而在检测M2/M3段血管内血栓的灵敏度存在显著差异(SWI：75.0%;MRA：37.5%;P<0.001)。结论 SWI和MRA均能检测到急性脑梗死中血管内血栓性闭塞或狭窄,其在检测主要血管狭窄或闭塞方面的灵敏性没有差别,但是在检测较小、迂曲动脉段及髓静脉方面SWI更具有优越性。     

The utility of neuroimaging in the evaluation of children with migraine or chronic daily headache who have normal neurological examinations

OBJECTIVES: To assess the utility of neuroimaging in the evaluation of children presenting with two of the most common forms of headache, migraine and chronic daily headache, and to determine the utility and pathological yield of neuroimaging in specific headache syndromes in children whose neurological examinations are normal. METHODS: We retrospectively reviewed the medical records of patients coded for headache (ICD 784) in the Pediatric Neurology Clinic at Children's Hospital of the King's Daughters between 1997 and 1999. The age range considered was between 6 and 18 years. The study focused on the two most common types of headache, uncomplicated migraine and chronic daily headache. Only patients with normal physical and neurological examinations were considered in this analysis. RESULTS: Three hundred two patients were coded for headache within the defined age group. One hundred seven (35.4%) patients fulfilled IHS-R criteria as having uncomplicated migraine with a normal examination, and 30 (9.9%) patients fulfilled criteria for chronic daily headache. Twenty-nine (9.6%) patients presented with migrainelike symptoms, and 6 (2.0%) presented with chronic daily symptoms, but had neurological abnormalities present on examination. The remainder of the patients with headache had the following etiologies: 50 (16.6%) with secondary headache, 22 (7.3%) with complicated migraine, 20 (6.6%) with posttraumatic headache, 13 (4.3%) with seizure-related headache, 11 (3.6%) with brain tumors, 10 (3.3%) with tension-type headache, and 4 (1.3%) with pseudotumor cerebri. Of the 107 patients with migraine, 42 (39.3%) received CT scans; 2 (4.8%) of which were considered "abnormal." One of the abnormalities was an arachnoid cyst and the other was a dilated Virchow-Robin space. Twelve (11.2%) patients with migraine received an MRI, 2 (16.7%) of which were considered abnormal. Both of the abnormal findings were Chiari type I malformations. Of the 30 patients with chronic daily headache, 17 (56.7%) received CT scans, 3 (17.6%) of which were considered abnormal. The abnormalities consisted of a maxillary opacification, a mucous retention cyst, and an occult vascular malformation. Eight (26.7%) of the patients with chronic daily headache had an MRI, 2 (25.0%) of which were abnormal. One of the abnormalities was a Chiari I malformation, and the other was an occult vascular malformation. CONCLUSION: The yield of neuroimaging in children with uncomplicated migraine and normal neurological examination was 3.7%. The yield in children with chronic daily headache and normal neurological examination was higher at 16.6%. The abnormalities discovered included arachnoid cysts, Chiari I malformations, sinus disease, occult vascular malformations and "dilated Virchow-Robin spaces." While none of the neuroimaging findings were apparent clinically, their discovery did not influence the diagnosis, management, or outcome of the patients. None of the abnormalities necessitated surgical intervention or were associated with the headache presentation. Therefore, neuroimaging is not warranted in children and adolescents with defined clinical headache syndrome diagnoses whose neurological examinations are normal.     

64排CT检测颈动脉粥样斑块与缺血性脑卒中及颅内动脉瘤关系的研究

目的:探讨颈动脉粥样斑块与缺血性脑卒中、颅内动脉瘤的关系。方法:分别对104例缺血性脑卒中患者和126例健康体检者进行回顾性分析。所有病例均行头颈部64排CT血管造影,分析并记录颈动脉粥样斑块的类型、狭窄程度及颅内动脉瘤。结果:(1)梗塞侧颈动脉的中度狭窄率、重度狭窄或闭塞率明显高于正常侧,差异具有统计学意义(P<0.001)。梗塞侧颈动脉的易损斑块率明显高于正常侧,差异具有统计学意义(P<0.001)。(2)颈动脉粥样硬化组颅内动脉瘤发生率高于无硬化组,差异具有统计学意义(P=0.037)。结论:(1)颈动脉狭窄、易损斑块是缺血性脑卒中的重要危险因素。(2)颈动脉粥样硬化对颅内动脉瘤的发生、发展起着重要作用,同时增加了患者的危险性。(3)64排CT能清晰显示颈动脉狭窄及粥样斑块的形态和成分,可作为临床首选的检查方法。