256层螺旋CT血管造影在颅外脑动脉支架内再狭窄的诊断价值

摘要

Objective To evaluate the value of 256 slices CT angiography (CTA) in the diagnosis of in‐stent restenosis (ISR) for the patients with extracranial artery stenting .Methods Between Dec .2010 and Nov 2012 ,endovascular stent‐ing angioplasty was performed in 16 patients with carotid artery stenosis ,15 patients with vertebral artery stenosis and 6 patients with subclavian artery stenosis .256‐slice CTA was performed to evaluate the stent patency ,and the ISR was clas‐sified into 4 patterns .Results ISR was found in 11 patients with carotid artery stents (6 cases with pattern Ⅰ B ,2 cases with pattern Ⅰ C ,2 cases with pattern Ⅱ ,and 1 case with pattern Ⅳ ) ,and 10 patients with vertebral artery stents (1 case with pattern Ⅰ A ,pattern Ⅰ B ,pattern Ⅰ C ,respectively ;5 cases with pattern Ⅱ ;1 case with pattern Ⅲ and pat‐tern Ⅳ ,respectively) ,and 5 patents with subclavian artery stents ( 1 case with pattern Ⅰ A and pattern Ⅰ C ,respective‐ly ;3 cases with pattern Ⅱ) .Conclusion 256‐slice CTA is favorable for demonstrating the ISR and help to investigate the reason of ISR ,which becomes one of preferred imaging methods for the follow‐up after stenting .%目的探讨256层螺旋CT血管造影（CT angiography ，CTA）在颅外脑动脉支架内再狭窄（ISR）的诊断价值。方法16例颈内动脉、15例椎动脉及6例锁骨下动脉支架植入手术患者行256层C T A检查，重点评估支架内通。情况，将再狭窄病变分为4型。结果16例颈动脉支架中，11例可见IS R ，包括ⅠB型病变6例，ⅠC型病变2例，Ⅱ型病变2例，Ⅳ型病变1例；15例椎动脉支架中，10例可见IS R ，包括ⅠA型、ⅠB型、ⅠC型病变各1例，Ⅱ病变5例，Ⅲ型病变和Ⅳ型病变各1例；6例锁骨下动脉支架中，5例可见IS R ，包括ⅠA型和ⅠC型病变各1例，Ⅱ型病变3例；病变在随访中缓慢进展。结论256层CTA可以对颅外脑动脉支架术后ISR作出准确诊断并帮助分析其原因，是随访的首选影像学检查方法之一。