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目的探讨多层螺旋CT血管成像(MSCTA)与彩色多普勒血流显像(CDFI)在评价脑梗死患者颈动脉粥样硬化病变中的价值。方法对195例脑梗死患者在7天内行颈动脉CDFI和MSCTA检查。分别对颈动脉分叉部内-中膜厚度(IMT)/管壁厚度(CAWT)、斑块表面形态学特征、密度、体积进行分析,将病变分为管壁增厚、稳定斑块和易损斑块。结果 195例患者390处颈动脉分叉部血管纳入分析。MSCTA:正常血管71处(18.21%);CAWT增厚87处(22.31%);斑块232处(59.49%),其中稳定斑块140处(35.90%),易损斑块92处(23.59%)(包括溃疡型斑块5处)。CDFI:正常血管80处(20.51%);IMT增厚86处(22.05%);斑块224处(57.44%),其中稳定斑块136处(34.87%),易损斑块88处(22.56%)(包括溃疡型斑块4处)。MSCTA与CDFI对脑梗死患者颈动脉粥样硬化病变评价的一致性为72.60%(Kappa=0.63,P<0.05)。结论 MSCTA与CDFI对评价脑梗死患者颈动脉粥样硬化病变具有较好的一致性。颈动脉CDFI应作为首选检查,经CDFI检查存在血管病变者应常规接受MSCTA检查。
Objective To investigate the value of multislice spiral CT angiography (MSCTA) and color Doppler flow imaging (CDFI) in the evaluation of carotid atherosclerosis in patients with cerebral infarction. Methods 195 patients with cerebral infarction underwent carotid artery CDFI and MSCTA within 7 days. The intima-media thickness (IMT) / wall thickness (CAWT) of the carotid bifurcation, the surface morphological features, density and volume of the carotid bifurcation were analyzed respectively. The lesions were divided into wall thickening, stable plaque and vulnerable Plaque. Results Blood vessels of 390 patients with carotid artery bifurcation were included in the analysis. MSCTA: 71 (18.21%) of normal vessels; 87 (22.31%) of CAWT thickening and 232 (59.49%) of plaques, including 140 stable plaques (35.90%), 92 vulnerable plaques (23.59% ) (Including 5 ulcer plaques). CDFI: 80 normal vessels (20.51%), 86 (22.05%) IMT thickening and 224 (57.44%) plaques, of which 136 were stable plaques (34.87%), 88 were vulnerable plaques (22.56% ) (Including 4 ulcerative plaques). The agreement between MSCTA and CDFI in evaluating carotid atherosclerosis in patients with cerebral infarction was 72.60% (Kappa = 0.63, P <0.05). Conclusion MSCTA and CDFI have good consistency in the evaluation of carotid atherosclerosis in patients with cerebral infarction. Carotid artery CDFI should be the first choice of examination, CDFI examination of vascular lesions should be routinely accepted MSCTA examination.