超声、CT血管造影在诊断颈动脉粥样硬化斑块中的应用价值

目的观察超声、CT血管造影(CTA)对颈动脉狭窄患者颈动脉粥样硬化斑块数量、分布、性质及颈动脉狭窄程度的评估价值。方法选取2018年1月~2018年12月本院50例拟诊为颈动脉狭窄患者为研究对象,患者于入院一周内完成彩色多普勒超声(CDUS)及CTA检查,观察双侧颈总动脉(CCA)、颈内动脉(ICA)、颈外动脉(ECA)斑块数量、分布、性质,分析颈动脉中重度狭窄率。结果 CTA在ICA上斑块检出数量明显多于CDUS;两种检查方式在ICA各类型斑块检出数上差异有统计学意义(P<0.05);CDUS对CCA上易损斑块检出率显著高于CTA(P<0.05);CTA颈动脉中重度狭窄检出率98.0%,显著高于CTA的84.0%(P<0.05)。结论 CTA在ICA段斑块检出、颈动脉狭窄评估中具有优势,而CDUS能更好判断斑块表面是否规则或存在溃疡,在CCA易损斑块评估中更具价值,两种检查方式各有优缺点,临床应用时可相互配合,为颈动脉狭窄患者诊疗提供更有力依据。

Application Value of Ultrasound and CT Angiography in the Diagnosis of Carotid Atherosclerotic Plaque

Objective To observe the evaluated value of ultrasound and CT angiography on quantity, distribution and nature of carotid atherosclerotic plaque and carotid stenosis degree in patients with carotid artery stenosis. Methods From January 2018 to December 2018, 50 patients diagnosed with carotid artery stenosis in the hospital were selected for the study. Color Doppler ultrasonography(CDUS) and CTA were performed within one week after admission. The plaque quantity, distribution and nature in bilateral common carotid artery(CCA), internal carotid artery(ICA) and extracranial artery(ECA) were observed, and the moderate-severe stenosis rate in carotid artery was analyzed. Results The quantity of plaques in ICA detected by CTA was significantly higher than that by CDUS. There was a statistically significant difference in the detected quantity plaques in ICA between the two methods(P<0.05). The detection rate of vulnerable plaques on CCA by CDUS was significantly higher than that by CTA(P<0.05). The detection rate of moderate-severe stenosis in carotid artery by CTA was significantly higher than that by CTA(98.0% vs 84.0%)(P<0.05). Conclusion CTA has an advantage in the detection of plaque detection and carotid stenosis in the ICA segment, and CDUS can better determine whether the plaque surface is regular or ulcerated, and it is more valuable in the assessment of CCA vulnerable plaques. There are advantages and disadvantages in the two examination methods, and they can cooperate with each other in clinical application so as to provide a more powerful basis for the diagnosis and treatment of patients with carotid artery stenosis.