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目的探讨颈动脉粥样硬化斑块性质和成分、斑块发生部位、动脉管腔狭窄程度与缺血性脑梗死的关系。资料与方法回顾性分析164例临床诊断并经CT或MRI证实的缺血性脑梗死患者资料。164例均行双源CT血管造影检查。对颈动脉颅外段及颅内段较大分支进行评价,重点分析颈动脉粥样斑块的性质和成分、斑块好发部位以及造成颈动脉管腔的狭窄程度等,并与138例对照组颈动脉粥样硬化斑块检出情况进行比较。结果164例中,颈动脉颅外段斑块137例(占83.5%),其中颈动脉分叉处斑块好发(97/137,70.8%)。颈动脉单纯斑块75例,其中非钙化性斑块(含多发)26例,占15.9%,钙化斑块(含多发)49例,占29.9%;颈动脉混合性斑块89例,占54.2%。72例颈动脉管腔中-重度狭窄患者中,52例(占72.2%)伴发同侧脑梗死;12例颈动脉闭塞患者中,11例(占91.7%)伴发同侧脑梗死。颈动脉粥样硬化斑块成分和检出数量与脑梗死有明显的相关性(P<0.005)。结论缺血性脑梗死与颈动脉粥样斑块的性质和成分、斑块的数量、斑块的发生部位及管腔的狭窄程度密切相关;双源CT血管造影可作为缺血性脑梗死病因的检查方法之一。
Objective To investigate the relationship between carotid atherosclerosis plaque characteristics and components, plaque location, arterial stenosis and ischemic cerebral infarction. Materials and Methods Retrospective analysis of 164 cases of clinical diagnosis and confirmed by CT or MRI in patients with ischemic cerebral infarction. 164 cases were double-source CT angiography. The extracranial and intracranial segments of the carotid artery were evaluated. The characteristics and components of carotid atherosclerotic plaque, the site of plaques and the stenosis of the carotid artery lumen were analyzed emphatically. The results were compared with 138 controls Group carotid atherosclerotic plaque detection were compared. Results Of the 164 cases, 137 cases (83.5%) had carotid extracranial plaques, of which carotid bifurcation plaques were predominant (97/137, 70.8%). There were 75 carotid simple plaques, of which 26 cases were noncalcified plaques (including multiple), accounting for 15.9%, 49 cases were calcified plaques (including multiple), accounting for 29.9%; 89 cases were carotid mixed plaques, accounting for 54.2 %. Of the 72 patients with moderate to severe carotid stenosis, 52 (72.2%) had ipsilateral cerebral infarction. Of the 12 patients with carotid artery occlusion, 11 (91.7%) had ipsilateral cerebral infarction. Carotid atherosclerosis plaque composition and the number of detected significant correlation with cerebral infarction (P <0.005). Conclusions The ischemic cerebral infarction is closely related to the nature and composition of carotid atherosclerotic plaque, the number of plaques, the location of plaque and the stenosis of the lumen. Dual-source CT angiography can be used as the cause of ischemic cerebral infarction One of the methods of inspection.