本文選題：斑塊內(nèi)出血 + 頸動脈狹窄　； 參考：《中國老年學雜志》2017年15期

【摘要】：目的探索64層螺旋CTA評估頸動脈斑塊內(nèi)出血的應用價值。方法選擇2014年9月至2015年6月于大連醫(yī)科大學附屬第二醫(yī)院神經(jīng)內(nèi)科住院患者為研究對象,將經(jīng)頸部血管彩超發(fā)現(xiàn)單側或雙側頸動脈狹窄50%~99%的患者納入本研究,對所有納入研究的患者完成頸動脈MRI及CTA檢查,并根據(jù)MRI檢查結果將其分為斑塊內(nèi)出血(IPH)組和非IPH組,比較兩組CTA影像學特點(包括斑塊內(nèi)CT值以及是否存在斑塊潰瘍)的差異性。結果單側或雙側頸動脈狹窄50%~99%的患者97例,狹窄頸動脈共114條,其中存在IPH者67例,IPH的發(fā)生率約為58.8%。CTA檢查結果示IPH組斑塊內(nèi)平均CT值為(87.13±14.82)HU,非IPH組為(35.17±12.47)HU,兩組比較存在統(tǒng)計學差異(P0.05)。CTA檢查結果示IPH組存在斑塊潰瘍者53例(79.1%),非IPH組5例(10.6%);CTA評估斑塊潰瘍的敏感性為79.1%,特異性為89.4%,陽性預測值為91.4%,陰性預測值為75%,兩組在是否存在斑塊潰瘍方面存在統(tǒng)計學差異(P0.05)。結論對于存在MRI檢查禁忌的患者,可使用CTA對頸動脈斑塊進行評估,以斑塊內(nèi)CT值以及斑塊潰瘍作為評價指標,從而更好地指導下一步治療。
[Abstract]:Objective to explore the value of 64-slice spiral CTA in the evaluation of carotid plaque hemorrhage. Methods patients in Department of Neurology, second affiliated Hospital of Dalian Medical University from September 2014 to June 2015 were selected as subjects. 50% or 99% of patients with unilateral or bilateral carotid artery stenosis were detected by color Doppler sonography. Carotid MRI and CTA were performed in all patients who were included in the study, and were divided into plaque hemorrhage (IPH) group and non-IPH group according to MRI findings. The imaging features of CTA (including intraplaque CT value and plaque ulcer) were compared between the two groups. Results 97 cases of unilateral or bilateral carotid artery stenosis were 50% and 99%, with 114 carotid artery stenosis. The incidence of IPH in 67 cases with IPH was about 58.8%. The results of CTA showed that the average CT value of plaque in IPH group was (87.13 鹵14.82) HUU, and that in non-IPH group was (35.17 鹵12.47) HU.There was statistical difference between the two groups (P0.05) .CTA showed that 53 cases (79.1%) had plaque ulcer in IPH group and 55.1% in non-IPH group. The sensitivity, specificity, positive predictive value and negative predictive value of CTA for plaque ulcer were 79.1, 89.4, 91.4 and 75, respectively (P0.05). Conclusion CTA can be used to evaluate carotid plaques in patients with contraindication of MRI examination. Ct value of plaque and plaque ulcer can be used as evaluation index, so as to better guide the next treatment.
【作者單位】： 大連醫(yī)科大學附屬第二醫(yī)院神經(jīng)內(nèi)3科;
【基金】：遼寧省科技廳社發(fā)攻關及成果產(chǎn)業(yè)化項目(2013225002)
【分類號】：R743.3;R816.1
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本文編號：2074685