中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
10期
1026-1029
,共4页
胡伟%汤其强%任明山%王国平
鬍偉%湯其彊%任明山%王國平
호위%탕기강%임명산%왕국평
体层摄影术%X线计算机%支架成形术%颈动脉狭窄%钙化斑块
體層攝影術%X線計算機%支架成形術%頸動脈狹窄%鈣化斑塊
체층섭영술%X선계산궤%지가성형술%경동맥협착%개화반괴
Body section radiography%X-ray computed tomography%Stenting%Carotid stenosis%Calcification plaque
目的 评估CT血管造影(CTA)检测血管内膜斑块对颈内动脉支架成形术(CAS)效果的预测价值. 方法 选取安徽医科大学附属省立医院神经内科自2008年12月至2011年4月行支架成形术(CAS)治疗的前循环缺血性脑血管病患者49例,根据CTA检测的颈内动脉斑块CT值将患者分为钙化组(24例)、非钙化组(25例),采用Agatston法计算钙化积分并将钙化组分为轻度钙化组(4例)、中度钙化组(12例)、重度钙化组(8例).比较钙化组和非钙化组患者行CAS后的残留狭窄率并分析钙化组患者Agatston分数与CAS后残余狭窄率的相关性. 结果 49支狭窄的颈内动脉行CAS,术后47支血管残留狭窄.钙化组CAS后平均残留狭窄率高于非钙化组患者,差异有统计学意义(P=0.001).轻度、中度、重度钙化组之间CAS后平均残留狭窄率依次增高,差异均有统计学意义(P＜0.05).钙化组Agatston分数与CAS后残留狭窄率呈正相关关系(r=0.941,P=0.001). 结论 CTA诊断颈内动脉狭窄是可靠的,以Agatston钙化分数对颈内动脉钙化斑块进行评估,对CAS具有一定的指导意义.
目的 評估CT血管造影(CTA)檢測血管內膜斑塊對頸內動脈支架成形術(CAS)效果的預測價值. 方法 選取安徽醫科大學附屬省立醫院神經內科自2008年12月至2011年4月行支架成形術(CAS)治療的前循環缺血性腦血管病患者49例,根據CTA檢測的頸內動脈斑塊CT值將患者分為鈣化組(24例)、非鈣化組(25例),採用Agatston法計算鈣化積分併將鈣化組分為輕度鈣化組(4例)、中度鈣化組(12例)、重度鈣化組(8例).比較鈣化組和非鈣化組患者行CAS後的殘留狹窄率併分析鈣化組患者Agatston分數與CAS後殘餘狹窄率的相關性. 結果 49支狹窄的頸內動脈行CAS,術後47支血管殘留狹窄.鈣化組CAS後平均殘留狹窄率高于非鈣化組患者,差異有統計學意義(P=0.001).輕度、中度、重度鈣化組之間CAS後平均殘留狹窄率依次增高,差異均有統計學意義(P＜0.05).鈣化組Agatston分數與CAS後殘留狹窄率呈正相關關繫(r=0.941,P=0.001). 結論 CTA診斷頸內動脈狹窄是可靠的,以Agatston鈣化分數對頸內動脈鈣化斑塊進行評估,對CAS具有一定的指導意義.
목적 평고CT혈관조영(CTA)검측혈관내막반괴대경내동맥지가성형술(CAS)효과적예측개치. 방법 선취안휘의과대학부속성립의원신경내과자2008년12월지2011년4월행지가성형술(CAS)치료적전순배결혈성뇌혈관병환자49례,근거CTA검측적경내동맥반괴CT치장환자분위개화조(24례)、비개화조(25례),채용Agatston법계산개화적분병장개화조분위경도개화조(4례)、중도개화조(12례)、중도개화조(8례).비교개화조화비개화조환자행CAS후적잔류협착솔병분석개화조환자Agatston분수여CAS후잔여협착솔적상관성. 결과 49지협착적경내동맥행CAS,술후47지혈관잔류협착.개화조CAS후평균잔류협착솔고우비개화조환자,차이유통계학의의(P=0.001).경도、중도、중도개화조지간CAS후평균잔류협착솔의차증고,차이균유통계학의의(P＜0.05).개화조Agatston분수여CAS후잔류협착솔정정상관관계(r=0.941,P=0.001). 결론 CTA진단경내동맥협착시가고적,이Agatston개화분수대경내동맥개화반괴진행평고,대CAS구유일정적지도의의.
Objective To evaluate the prognostic value of intima calcification detection with CT angiography (CTA) in carotid artery stenting (CAS).Methods Forty-five patients with anterior circulation stroke,admitted to our hospital from December 2008 to April 2011,were chosen in our study;the patients were divided into two groups,one without calcification (n=25) and the other with calcification (n=24) according to CT density.The calcium scores were calculated according to the method described by Agatston.Patients in the calcification group were subdivided into mild calcification group (n=4),medium calcification group (n=12) and severe calcification group (n=8).Remained percentage of stenosis after CAS in the none calcification group and calcification group were compared; correlation between Agatston scores of the calcification patients and remained percentage of stenosis after CAS was analyzed.Results Remained stenosis after CAS was noted in 47 of the 49 internal carotid arteries,and remained percentage of stenosis after CAS in the none calcification group was significantly lower than that in the calcification group (P=0.001); the severer the stenosis in the mild calcification group,medium calcification group and severe calcification group,the higher the remained percentage of stenosis after CAS (P＜0.05).Degree of artery stenosis after CA S was closely correlated with Agatston scores (r=0.941,P=0.001).Conclusion CTA is reliable for diagnosing the carotid stenosis; evaluating carotid plaques with Agatston calcium scores is very useful for CAS.
