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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。
OBJECTIVE: To evaluate the relationship between the degree of vascular wall enhancement and plaque stability by analyzing the enhanced features of the vessel wall of the carotid atherosclerosis (AS). Methods: One hundred and forty-eight patients with clinically suspected neck stenosis were examined by CTA and 87 CE-MRA. The type of plaque was analyzed and the degree of enhancement of adjacent vessel wall and the degree of stenosis were evaluated. Relationship between features and plaque stability. Some patients in CTA group were compared with DSA. Results: In the CTA group, there were 74 stenotic vessels, 34 mild stenoses, 24 moderate stenoses, 19 severe stenoses and 3 complete occlusions; 32 soft plaques, 25 hard plaques, 6 ulcer spots and soft The plaque at the vessel wall was significantly enhanced than the hard plaque, some patients compared with DSA, the two methods of examination of vascular stenosis showed no significant difference. In the CE-MRA group, there were 79 stenotic vessels, 28 mild stenoses, 33 moderate stenoses, 13 severe stenoses and 5 complete occlusions. There were 28 soft plaques, 49 hard plaques, 2 thrombus, Blood vessel wall enhancement was significantly higher than the hard plaque. Conclusion: CTA and CE-MRA have their own advantages in evaluating the stability of carotid atherosclerotic plaque, which can provide very reliable and accurate information for clinical prediction of ischemic stroke.