摘要
摘要：目的：本研究比较多层螺旋CT血管造影（MS—CTA）和超声（US）检查对颈动脉粥样硬化性病变筛查的价值，并比较MS—CTA不同重建技术对诊断颈动脉狭窄的可靠性。方法：对31例症状性颈动脉粥样硬化病变患者同时作MS-CTA和US检查，并对其中的4例进行了数字减影血管造影（DSA）检查。MS-CTA重建方式包括多平面重建（MPR）、最大密度投影（MIP）和容积再现（VR）三种技术，分别在轴位、MPR、MIP和VR图像上测量颈动脉的狭窄程度。颈总动脉颈膨大和颈内动脉段起始段的狭窄率分别按欧洲颈动脉外科手术研究（ECST）、北美症状性颈动脉内膜剥脱术研究（NASCET）标准计算，然后将其分为五个等级：无狭窄、轻度狭窄（0％-29％）、中度狭窄（30％．69％）。重度狭窄（70％-99％）和完全闭塞。结果：31例患者共62条颈动脉，其中23条在MS-CTA和US上同时发现颈动脉斑块和狭窄，两种方法对诊断颈动脉粥样硬化性病变的一致性为81％。对颈动脉各段狭窄程度进行分级时，MS-CTA不同重建技术图像之间具有良好的相关性。与DSA比较，MS—CTA确诊3条颈内动脉闭塞。而其中1条US未能发现。结论：US、MS—CTA等非侵入性检查可较好地用于颈动脉狭窄的筛查，并在诊断颈动脉粥样硬化性病变方面具有互补作用。结合原始轴位图像并综合采用多种重建方式，MS—CTA可较好地用于评价颈动脉狭窄。
Objective：To compare multislice computed tomographic （MSCT） angiography with ultrasonography （US） screening for carotid atherosclerotic disease, and to determine the reliability of MS-CTA for evaluation of carotid arterial stenosis. Methods ： In 31 patients, 62 carotid arteries were analyzed by MS-CTA and US. The intra-arterial digital subtract angiography （DSA） was performed in 4 patients as well. Multiplanar reconstruction （ MPR ）, maximum intensity projection （MIP） and volume-rendered （VR） images were produced for each MS-CTA study. Carotid Arteries were measured on source axial, MPR, MIP and VR images separately. The degree of stenosis in each segmental artery was calculated according to the formula recommended by NASCET and ECST. Each segmental artery was then graded as no stenosis, mild（0% -29% ） stenosis, moderate（30% -69% ） stenosis, severe（70% -99% ） stenosis, or occlusion. ing carotid artery atherosclerosis with both MS-CTA and US was found in 23 （ 37% ） of the 62 carotid arteries studied, and the overall agreement of the screening for carotid atherosclerotic disease obtained from two methods was 81%. Agreement on stenosis category among source axial, MPR, MIP and VR images was found in 76（97% ） of the 78 segmental arteries studied. Correlation between MS-CTA and DSA was good. Three occlusions were diagnosed correctly by MS-CTA, one of which was not detected by US. Condusion：MS-CTA and US were significantly correlated in diagnosing carotid artery atherosclerosis, and complementing each other in screening for carotid atherosclerotic disease. Conjointly analyzing the source axial images, MSCT angiography with MPR, MIP and volume-rendering technique（VRT） can be used to adequately evaluate carotid stenosis.
出处
《医学研究生学报》
CAS
2006年第8期707-711,共5页
Journal of Medical Postgraduates
基金
国家自然科学基金资助项目(批准号:30470510)
关键词
颈动脉狭窄
CT血管造影
超声
数字减影血管造影
Carotid stenosis
Computed tomographic angiography
Ultrasound
Digital subtract angiography
