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目的采用双源CT血管造影(CTA)和高分辨MRI,探讨缺血性脑血管病患者颈总动脉分叉处粥样硬化斑块的性质、成分和动脉管腔狭窄程度与缺血性脑血管病的关系。方法选择缺血性脑血管病患者40例,经颈部CTA检测出颈总动脉分叉处粥样硬化斑块并伴管腔狭窄,再接受MRI扫描;分析颈动脉粥样斑块的性质、成分及管腔狭窄程度。结果 40例患者中,CTA检出斑块61个,其中混合性斑块31个;钙化性斑块18个;软斑块12个。高血压30例,检出斑块49个;无高血压10例,检出斑块12个。MRI检出斑块61个,其中Ⅲ型14个;Ⅳ～Ⅴ型23个,Ⅵ型6个;Ⅶ型18个。斑块内溃疡6例;颈动脉粥样硬化斑块造成同侧急性脑梗死14例,双侧颈动脉斑块造成双侧脑梗死10例,一侧颈动脉检出粥样斑块而对侧发生脑梗死2例。结论缺血性脑血管病患者颈动脉粥样硬化斑块主要以混合性斑块为主,双侧好发;高血压患者斑块发生率高于无高血压患者;颈动脉粥样硬化斑块造成同侧脑梗死发生率较高。
Objective To explore the characteristics of atherosclerotic plaque of common carotid artery in patients with ischemic cerebrovascular diseases by using dual-source CT angiography (CTA) and high-resolution MRI. The components and the degree of arterial stenosis and ischemic cerebrovascular The relationship between the sick. Methods Forty patients with ischemic cerebrovascular disease were selected. Cervical CTA was used to detect the atherosclerotic plaque in common carotid artery with stenosis of the lumen and MRI scan. The carotid atherosclerotic plaque was analyzed. Composition and extent of stenosis. Results Among the 40 patients, there were 61 plaques detected by CTA, including 31 mixed plaques, 18 calcified plaques and 12 soft plaques. Hypertension in 30 cases, plaque detection 49; no hypertension in 10 cases, plaque detection 12. There were 61 plaques detected by MRI, including 14 of type Ⅲ, 23 of type Ⅳ-Ⅴ, 6 of type Ⅵ and 18 of type Ⅶ. 6 cases of plaque ulcer; carotid atherosclerotic plaque caused by ipsilateral acute cerebral infarction in 14 cases, bilateral carotid plaque caused by bilateral cerebral infarction in 10 cases, one side of the carotid artery plaque detected contralateral Cerebral infarction occurred in 2 cases. Conclusions Carotid atherosclerotic plaques in patients with ischemic cerebrovascular disease are predominantly mixed plaques and occur on both sides. The incidence of plaque in hypertensive patients is higher than that in non-hypertensive patients. Carotid atherosclerosis plaques Resulting in a higher incidence of ipsilateral cerebral infarction.