多层螺旋CT血管成像在评价椎鄄基底动脉粥样硬化斑块稳定性中的应用价值

摘要

Objective To explore the clinical application of MSCTA in stability of vertebro-basilar atheroscle-rotic plaque. Methods One hundred and twenty cases of the patients with vertebro-basilar atherosclerotic plaque were taken CT angiography scanning, and ARI/CE-ARI post-processing reconstruction techniques were applyed. Cal-culate the average CT value of different types of plaques, the degree of enhancement in different types of plaques and vascular walls ,which were compared with those in the control group. Results There were 316 atherosclerotic plaques in 120 cases of patients with vertebro-basilar atherosclerotic plaque, including 85 non-calcified plaques, 103 mixed plaques and 128 calcified plaques. Thirty-eight cases were unilateral involved and 82 cases were bilateral in-volved. Statistical analysis showed that the difference between the enhancement of vessel walls in non-calcified plaque group and that in control group has statistical significance (t=8.21, P<0.01). Correlationship was shown between the enhancement of non-calcified plaques and the enhancement of vessel walls (r=0.97, P<0.01). Conclusion MSCTA excels in evaluating vertebro-basilar atherosclerotic plaque, stability of plaque, and provides reliable imaging features. The enhancement of vessel walls of vertebro-basilar atherosclerotic plaque have correlation with the stability of plaque.%目的：探讨多层螺旋CT血管成像（MSCTA）在评价椎-基底动脉粥样硬化斑块的稳定性中的应用价值研究。方法120例椎-基底动脉粥样硬化斑块的患者，扫描结束后进行平扫横轴位重组图像/增强扫描横轴位重组图像（ARI/CE-ARI）后处理重建技术；计算出不同类型斑块的平均CT值，对不同类型斑块的强化程度、不同类型斑块血管壁的强化程度和对照组进行比较。结果120例椎-基底动脉粥样硬化斑块患者中，单侧38例，双侧82例，共计发现斑块316处，其中非钙化斑块85处，混合斑块103处，钙化斑块128处。统计学分析显示非钙化斑块处血管壁强化程度与对照组之间差异有统计学意义（t＝8．21，P＜0．01），非钙化斑块的强化程度与管壁强化程度之间存在显著性相关（r＝0．97，P＜0．01）。结论 MSCTA在评价椎-基底动脉粥样硬化斑块成分、斑块稳定性等方面有着其独特的优势，可以提供可靠的影像学依据。椎-基底动脉粥样硬化斑块中，血管壁的强化程度与斑块的稳定性之间存在相关性。