超聲和多層螺旋CT血管造影檢測(cè)腦梗死患者顱外頸
發(fā)布時(shí)間：2018-11-17 11:04
【摘要】：研究背景腦梗死是威脅人類生命安全的三大殺手之一,其中三分之二的病例是動(dòng)脈硬化所致。頸動(dòng)脈硬化導(dǎo)致的頸動(dòng)脈狹窄是缺血性腦血管疾病的一個(gè)重要危險(xiǎn)因素。有些狹窄性病變甚至可能逐漸發(fā)展至完全閉塞。由此可見,對(duì)頸動(dòng)脈粥樣斑塊的準(zhǔn)確診斷和處理至關(guān)重要。準(zhǔn)確評(píng)估狹窄范圍、精確測(cè)量狹窄的程度和識(shí)別斑塊的形態(tài)、特征,是決定是否需要手術(shù)及選擇手術(shù)方式的關(guān)鍵。超聲(US)已被證明是一種良好的篩選頸動(dòng)脈斑塊的技術(shù)。它可以顯示血管走形、管腔內(nèi)徑、管壁內(nèi)-中膜厚度(IMT)及血管內(nèi)有無斑塊形成等。利用多普勒超聲還可獲得血流動(dòng)力學(xué)信息。多層螺旋CT血管造影(MSCTA)目前已廣泛應(yīng)用于頸動(dòng)脈的研究中。它可以清晰顯示斑塊性質(zhì)和確定狹窄程度。它可提供更多的病變細(xì)節(jié)和解剖信息,極大方便了臨床醫(yī)生對(duì)病變的評(píng)價(jià)和治療。 目的比較超聲和MSCTA對(duì)腦梗死患者頸動(dòng)脈斑塊的檢查一致性及對(duì)斑塊定位、定性、狹窄程度判定的臨床價(jià)值。 方法對(duì)65例腦梗死患者在一周內(nèi)進(jìn)行超聲和MSCTA檢查,分別觀察斑塊有無、位置、性質(zhì)及血管狹窄程度,并對(duì)其進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果65例腦梗死患者經(jīng)超聲和MSCTA檢查分別發(fā)現(xiàn)了42例、43例患者顱外頸動(dòng)脈斑塊,兩者對(duì)于頸動(dòng)脈粥樣硬化斑塊的檢出率差異無統(tǒng)計(jì)學(xué)意義,一致性約79%。超聲檢查還可以觀測(cè)頸動(dòng)脈內(nèi)-中膜厚度及血流動(dòng)力學(xué)改變。MSCTA除可檢測(cè)顱外頸動(dòng)脈頸段外,還可檢測(cè)頸動(dòng)脈巖骨段、海綿竇段及顱內(nèi)段等。 結(jié)論頸動(dòng)脈粥樣硬化和腦梗死的關(guān)系密切。超聲和MSCTA在對(duì)動(dòng)脈粥樣硬化的檢查中具有互補(bǔ)作用。
[Abstract]:Background Cerebral infarction is one of the three major killers threatening human life. 2/3 of the cases are caused by arteriosclerosis. Carotid stenosis due to carotid atherosclerosis is an important risk factor for ischemic cerebrovascular disease. Some narrow lesions may even gradually develop to complete occlusion. Therefore, it is very important for the accurate diagnosis and management of carotid atherosclerotic plaque. Accurately evaluating the extent of stenosis, accurately measuring the extent of stenosis and identifying the shape and characteristics of plaque are the key to determine whether surgery is necessary and how to choose surgical methods. Ultrasound (US) has proved to be a good technique for carotid plaque screening. It can show the shape of the vessel, the diameter of the lumen, the intramural thickness of (IMT) and the formation of plaque in the vessel. Hemodynamic information can also be obtained by Doppler ultrasound. Multislice spiral CT angiography (MSCTA) has been widely used in the study of carotid artery. It can clearly show the nature of plaque and determine the degree of stenosis. It can provide more details and anatomical information, and greatly facilitate clinicians to evaluate and treat the lesions. Objective to compare the consistency of ultrasonography and MSCTA in the diagnosis of carotid plaque in patients with cerebral infarction, and to evaluate the clinical value of plaque localization, qualitative analysis and degree of stenosis. Methods 65 patients with cerebral infarction were examined by ultrasound and MSCTA within one week. Results Forty-two patients and 43 patients with extracranial carotid artery plaque were found by ultrasound and MSCTA in 65 patients with cerebral infarction. There was no significant difference in the detection rate of carotid atherosclerotic plaque between the two groups, and the consistency was about 79%. MSCTA not only could detect the carotid artery, but also the petrosal bone segment, cavernous sinus segment and intracranial segment of the carotid artery, so that MSCTA could also detect the carotid artery intima-media thickness and hemodynamic changes of the carotid artery, such as the extracranial carotid artery, the petrosal bone segment, the cavernous sinus segment and the intracranial segment. Conclusion carotid atherosclerosis is closely related to cerebral infarction. Ultrasound and MSCTA play complementary roles in the detection of atherosclerosis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R743.3;R816.1
本文編號(hào)：2337552
[Abstract]:Background Cerebral infarction is one of the three major killers threatening human life. 2/3 of the cases are caused by arteriosclerosis. Carotid stenosis due to carotid atherosclerosis is an important risk factor for ischemic cerebrovascular disease. Some narrow lesions may even gradually develop to complete occlusion. Therefore, it is very important for the accurate diagnosis and management of carotid atherosclerotic plaque. Accurately evaluating the extent of stenosis, accurately measuring the extent of stenosis and identifying the shape and characteristics of plaque are the key to determine whether surgery is necessary and how to choose surgical methods. Ultrasound (US) has proved to be a good technique for carotid plaque screening. It can show the shape of the vessel, the diameter of the lumen, the intramural thickness of (IMT) and the formation of plaque in the vessel. Hemodynamic information can also be obtained by Doppler ultrasound. Multislice spiral CT angiography (MSCTA) has been widely used in the study of carotid artery. It can clearly show the nature of plaque and determine the degree of stenosis. It can provide more details and anatomical information, and greatly facilitate clinicians to evaluate and treat the lesions. Objective to compare the consistency of ultrasonography and MSCTA in the diagnosis of carotid plaque in patients with cerebral infarction, and to evaluate the clinical value of plaque localization, qualitative analysis and degree of stenosis. Methods 65 patients with cerebral infarction were examined by ultrasound and MSCTA within one week. Results Forty-two patients and 43 patients with extracranial carotid artery plaque were found by ultrasound and MSCTA in 65 patients with cerebral infarction. There was no significant difference in the detection rate of carotid atherosclerotic plaque between the two groups, and the consistency was about 79%. MSCTA not only could detect the carotid artery, but also the petrosal bone segment, cavernous sinus segment and intracranial segment of the carotid artery, so that MSCTA could also detect the carotid artery intima-media thickness and hemodynamic changes of the carotid artery, such as the extracranial carotid artery, the petrosal bone segment, the cavernous sinus segment and the intracranial segment. Conclusion carotid atherosclerosis is closely related to cerebral infarction. Ultrasound and MSCTA play complementary roles in the detection of atherosclerosis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R743.3;R816.1
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