CAJ | 학술논문

目的：评价双源CT血管成像（DSCTA）对颈动脉粥样硬化斑块的诊断价值，并探讨糖尿病对颈动脉斑块的影响。资料与方法选取145例临床确诊为缺血性脑卒中的患者，分为糖尿病组80例和非糖尿病组65例，均行头颈部DSCTA检查，采用曲面重建（CPR）、最大密度投影（MIP）、多平面重组（MPR）和容积再现（VR）等方法综合分析颈动脉斑块部位及性质，比较两组患者一般资料、斑块性质及部位的差别。结果糖尿病组体重指数及高血脂比例明显高于非糖尿病组（t=6.197，P<0.05；χ2=8.372，P<0.01）；糖尿病组斑块及易损斑块的发生率均高于非糖尿病组（χ2=11.617、9.388，P<0.01），两组斑块在颈动脉各部位的发生率差异无统计学意义（χ2=0.160、0.509、0.419、0.016，P>0.05），以颈动脉分叉部及颈内动脉虹吸部多见。结论 DSCTA能更好地显示缺血性脑卒中患者的颈动脉斑块，能明确定位斑块及准确地分析斑块性质；糖尿病是颈动脉斑块形成的高危因素，更易促成易损斑块的形成。
목적：평개쌍원CT혈관성상（DSCTA）대경동맥죽양경화반괴적진단개치，병탐토당뇨병대경동맥반괴적영향。자료여방법선취145례림상학진위결혈성뇌졸중적환자，분위당뇨병조80례화비당뇨병조65례，균행두경부DSCTA검사，채용곡면중건（CPR）、최대밀도투영（MIP）、다평면중조（MPR）화용적재현（VR）등방법종합분석경동맥반괴부위급성질，비교량조환자일반자료、반괴성질급부위적차별。결과당뇨병조체중지수급고혈지비례명현고우비당뇨병조（t=6.197，P<0.05；χ2=8.372，P<0.01）；당뇨병조반괴급역손반괴적발생솔균고우비당뇨병조（χ2=11.617、9.388，P<0.01），량조반괴재경동맥각부위적발생솔차이무통계학의의（χ2=0.160、0.509、0.419、0.016，P>0.05），이경동맥분차부급경내동맥홍흡부다견。결론 DSCTA능경호지현시결혈성뇌졸중환자적경동맥반괴，능명학정위반괴급준학지분석반괴성질；당뇨병시경동맥반괴형성적고위인소，경역촉성역손반괴적형성。
PurposeTo evaluate the value of dual-source CT angiography (DSCTA) in the diagnosis of carotid atherosclerosis, and to explore the relationship between carotid atherosclerosis and diabetes mellitus (DM).Materials and Methods 145 patients with ischemic stroke were divided into DM group (n=80) and non-DM group (n=65). All patients underwent DSCTA. The location and characteristic of carotid atherosclerosis were analyzed using curve planE reconstruction (CPR), maximum intensity projection (MIP), multi-plane reformation (MPR) and volume rendering (VR). The differences between two groups were analyzed.Results Compared with non-DM group, the body mass index and high blood cholesterol were higher in DM group (t=6.197,P<0.05;χ2=8.372,P<0.01). The incidence of carotid atherosclerosis and vulnerable plaques were also higher in DM group than non-DM group (χ2=11.617 and 9.388,P<0.01). There was no significant difference between DM group and non-DM group in the location of carotid atherosclerosis (χ2=0.160, 0.509, 0.419 and 0.016,P>0.05). Carotid atherosclerosis was more common in carotid bifurcation and carotid artery siphon.Conclusion DSCTA can demonstrate the location and characteristics of carotid atherosclerosis in ischemic stroke patients with diabetes mellitus. Diabetes is a risk factor for the formation of carotid atherosclerosis, especially vulnerable plaques.