颈动脉粥样硬化斑块性质与颅内血流动力学变化的相关性

目的利用16排螺旋CT血管成像及灌注成像探讨颈动脉粥样硬化斑块性质与颅内血流动力学的相关性。方法对42例颈动脉超声证实的颈动脉斑块患者行16排螺旋CT灌注成像-血管成像检查,根据CT值的不同分析斑块成分,并将脂肪斑块和纤维斑块定义为不稳定性斑块,钙化斑块定义为稳定性斑块;利用灌注成像分析颅内脑血流灌注情况。结果42例颈动脉斑块患者中不稳定性斑块25例,其中脂肪斑块10例,纤维斑块15例;稳定性斑块17例。14例表现为症状相应区域低灌注,其中脂肪斑块颅内低灌注的发生率为70%,纤维斑块颅内低灌注的发生率为47%,而钙化斑块无颅内低灌注表现。结论不稳定性斑块的存在比较稳定性斑块易于引起颅内血流动力学变化。

Relationship Between Features of Carotid Atherosclerotic Plaques and Cerebral Hemodynamic Status

Aim To explore the relationship between the feature of carotid atherosclerotic plaque and cerebral hemodynamic status by 16-slice spiral computed tomography (CT). Methods 42 cases with carotid atherosclerotic plaques tested by carotid ultra-sonography had CT perfusion (CTP) and CT angiography (CTA). The CT values (housefield value,HV) of the major plaque components were assessed. According to different CT values, plaques were defined as stable (including lipid core and fibrous tissue) or instable (calcification ). Then CTP was used to evaluate the cerebral hemodynamic status. Results Among 42 cases, 25 cases had instable plaques. Of which a lipid core was found in 10 cases and fibrous tissue in 15 cases. Hypo-perfusion status was occurred in 14 cases, while 70% in lipid core, and 47% in fibrous tissue, but none in calcification tissue. Conclusion Instable plaque is more relative with hypo-perfusion than stable plaque.