颈动脉增强对评价颈动脉斑块稳定性的作用

目的:通过分析颈动脉粥样硬化(AS)血管壁的强化特征,评价血管壁强化程度与斑块稳定性之间的关系.方法:148例临床疑为颈部血管狭窄的患者中61例行CTA、87例行CE-MRA检查,分析斑块的类型并测量邻近血管壁的强化程度以及管腔狭窄程度,评价管壁强化特征与斑块稳定性之间的关系.CTA组部分患者与DSA对照.结果:CTA组:狭窄血管74支,轻度狭窄34支,中度狭窄24支,重度狭窄19支,3支完全闭塞;软斑块32块,硬斑块25块,溃疡斑6块,软斑块处血管壁强化明显高于硬斑块,部分患者与DSA比较,二种检查方法对血管狭窄的显示无显著性差异.CE-MRA组:狭窄血管79支,轻度狭窄28支,中度狭窄33支,重度狭窄13支,5支完全闭塞;软斑块28块,硬斑块49块,血栓2块,软斑块处血管壁强化明显高于硬斑块.结论:CTA和CE-MRA在评价颈动脉粥样硬化斑块的稳定性方面各有优势,能够为临床预测缺血性脑卒中提供非常可靠准确的信息.

Assessing the Stability of Carotid Artery Atherosclerotic Plaques by CTA and CE-MRA

Objective:To assess the correlation of carotid artery atherosclerosis (AS) plaque stability and enhancement character of the vessel wall by analyzing AS vessel wall with CTA and CE-MRA.Methods:148 patients who were suspected of having carotid artery stenosis were examined with CTA (61 cases) and CE-MRA (87 cases) respectively.The enhancement degree of vessel wall,modalities of AS plaque and the stenosis degree of carotid artery were analyzed.The relationship of AS plaque stability and enhancement character of the vessel wall was evaluated.Results:CTA group:in 74 stenosis carotid artery,the number of slight,medium,high degree of stenosis were 34,24,19 respectively,with 3 in complete occlusion;the number of soft plaque,hard plaque and ulcer plaque were 32,25,6 respectively.The enhancing degree of the soft plaques was obviously higher than that of the hard plaques.Comparing CTA with DSA,there was no statistical difference between them to show the stenosis.CE-MRA group:in 79 stenosis carotid artery,the number of slight,medium and high degree of stenosis were 28,33,13 respectively,with 5 in complete occlusion;the number of soft plaque,hard plaque and thrombus were 28,49,2 respectively.The enhancing degree of the soft plaques was obviously higher than that of the hard plaques.Conclusion:CTA and CE-MRA have their own advantage to estimate the stability of carotid artery atherosclerotic plaque.They can provide very credible and accurate information for clinic to prognosticate ischemic stroke.