摘要
目的：探讨短暂性脑缺血发作（TIA）患者颈动脉狭窄及斑块性质与脑卒中危险性的关系。材料与方法：对26例临床诊断为TIA的病人行头颅CT平扫，脑CT灌注和颈动脉血管成像。评价脑CT灌注成像的峰值时间（TTP），脑血流量（CBF），脑血容量（CBV）等脑血流动力学改变，以及颈动脉的狭窄程度及斑块的性质。结果：26例TIA患者中，CTA显示颈动脉狭窄19例，轻度7例（37%），中度8例（42%），重度4例（21%）；发现颈动脉斑块44处，其中混合性斑块9处，钙化性斑块22处，纤维性斑块7处，脂质性斑块6处。老年组钙化性斑块明显高于中青年组，P＜0.05，有显著性差异。在26例TIA患者中，21例头颅CT平扫正常，5例有腔隙性脑梗塞，其中多发2例。26例脑CTP检查，异常17例，正常9例，17例脑CTP异常患者患侧与对侧的平均TTP分别为（11.25±1.94）s和（8.64±0.96）s, 经配对t检验：t=9.418，P<0.01，两者间差异有非常显著性意义；两侧平均CBF、平均CBV均无统计学意义。随访6个月中3例发生脑梗塞。结论：TIA患者颈内动脉狭窄与脑卒中的发生密切相关。CT脑灌注成像结合CTA，不仅可以发现颈动脉有无狭窄及斑块的性质，还可以了解脑组织的血流动力学改变和脑组织的损害情况，具有较高的临床应用价值。
Abstract
Objective: To evaluate the relationship between internal carotid artery stenosis, plaques properties and stroke occurrence in transient ischemic attacks(TIA). Materials and Methods: Conventional CT, CT angiography(CTA) and CT perfusion imaging were performed in 26 patients with clinically diagnosed TIA. The time to peak(TTP), cerebral blood flow(CBF) and cerebral blood volume(CBV) were calculated. The stenosis of carotid artery was also assessed. Results: In 26 cases with TIA, CTA showed 19 cases of internal carotid artery stenosis, mild stenosis in 7 cases(37%), moderate stenosis in 8 cases(42%), severe stenosis in 4 cases(21%). Carotid plaques in 44 places, including 9 mixed plaques, 22 calcified plaques, 7 fibrous plaques, 6 lipid plaques. Old-age incidence was obviously higher than middle-aged group(P<0.05). In 26 cases with TIA, there were 21 normal cases and 5 cases with lacunar infarction, 2 cases had multiple arteries involvement on plain CT scan. Seventeen patients had abnormal CT perfusion and 9 had normal CT perfusion in 26 cases. The TTP of affeted side (11.25±1.94)s compared with that of the contralateral side (8.64±0.96)s was significantly prolonged(t=9.418, P<0.01). The difference of the CBF and CBV was not statistically significant between both sides. Follow-up of 6 months in 3 cases had cerebral infarction. Conclusion: Cerebral apoplexy and internal carotid artery stenosis has close relationship in TIA patients. CT perfusion and CTA can provide valuable diagnostic informations for patients with TIA.
关键词
脑缺血发作 /
短暂性 /
颈动脉狭窄 /
脑血管意外 /
体层摄影术 /
螺旋计算机
Key words
Ischemic attack /
transient /
Carotid stenosis /
Cerebrovascular accident /
Tomography /
spiral computed
徐方元;陈 爽;陈晓荣;韩云学;徐 瑛;毛宜虎;于 岚;王建民;叶春梅;叶春燕.
短暂性脑缺血患者颈内动脉狭窄与卒中危险性的相关性分析[J]. 中国临床医学影像杂志. 2011, 22(11): 761-765
XU Fang-yuan;CHEN Shuang;CHEN Xiao-rong;HAN Yun-xue;XU Ying;MAO Yi-hu;YU Lan;WANG Jian-min;YE Chun-mei;YE Chun-yan.
Correlation of internal carotid artery stenosis and risk of stroke inpatients with transient ischemic attacks[J]. Journal of China Clinic Medical Imaging. 2011, 22(11): 761-765
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