多层螺旋CT血管成像对颈动脉狭窄性短暂性脑缺血发作的诊断

摘要

目的 探讨多层螺旋CT血管成像(MSCTA)在颈动脉狭窄性短暂性脑缺血发作(TIA)中的诊断.方法 对26例临床诊断为TIA的患者行颈动脉MSCTA检查,将扫描数据进行多平面重建(MPR)、最大密度投影(MIP)和容积再现(VR)等图像后处理.其中8例进一步行颈动脉DSA检查.结果 26例TIA患者中19例有不同程度颈动脉狭窄,其中轻度狭窄7例(37%),中度狭窄8例(42%),重度狭窄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.随访6个月中3例发生脑梗死.结论 MSCTA能很好地显示颈动脉管腔有无狭窄、程度及斑块的性质,对颈内动脉TIA的病因诊断、治疗方案的确定以及预后估计具有较高的临床价值.%Objective To explore the diagnostic value of multi-slice spiral CT angiography(MSCTA) in transient ischemic attack (TIA) resulted from carotid arterial stenosis. Methods 26 patients with TIA underwent carotid MSCTA. Multi-planar reconstruction(MPR) , maximum intensity projection(MIP) and volume rendering(VR) were reconstructed. Among them, 8 patients underwent digital subtraction angiography (DSA). Results Among the 26 cases, MSCTA showed carotid arterial stenosis in different degree in 19 cases, including mild stenosis in 7 casesf 37% ), moderate stenosis in 8 cases (42%) and severe stenosis in 4 cases(21%). Tolally 44 carotid plaques were found,including mixed plaques(9) , calcified plaque(22) ,fibrous plaques(7) and lipid plaques(6). 26 patients were all followed-up for 6 months,of them, cerebral infarction occurred in 3. Conclusion MSCTA can reveal the existence and degree of carotid arterial stenosis and the character of carotid plaques,and also can predict the stroke, which is helpful to interfere in patients with TIA in early stage.