脑梗死患者牛津郡社区脑卒中项目分型256层螺旋CT头颈部血管成像特点分析
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河北省医学适用技术跟踪项目(GL2011-61);唐山市科技攻关计划项目(12140209A-37)


Characteristics Analysis of Head and Neck CTA of 256-slice CT Angiography in Patients with Cerebral Infarction of Oxfordshire Community Stroke Project Classification
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    摘要:

    目的 分析脑梗死患者牛津郡社区脑卒中项目(OCSP)分型各亚型256层螺旋CT头颈部血管成像特点,探讨脑梗死患者责任病灶侧头颈部动脉狭窄、狭窄程度和狭窄部位与OCSP分型各亚型之间的关系。方法 回顾分析300例急性脑梗死患者256层螺旋CT头颈部血管成像检查结果,并依据OCSP分型标准分为:完全前循环梗死(TACI)型(37例)、部分前循环梗死(PACI)型(109例)、后循环梗死(POCI)型(66例)和腔隙性梗死(LACI)型(88例),比较各型患者头颈部责任血管病变的特点。结果 OCSP分型TACI、PACI、POCI和LACI各亚型脑梗死患者责任病灶侧头颈部责任动脉血管狭窄或闭塞的检出率分别为86.8%、75.3%、88.5%和86.3%,各亚型之间头颈部责任动脉血管狭窄或闭塞的检出率比较,差异无显著性(P>0.05)。OCSP分型各亚型患者责任病灶侧头颈部责任动脉血管狭窄程度中,TACI亚型以重度狭窄或闭塞为主,PACI和LACI亚型以轻、中度狭窄为主,POCI亚型以轻度狭窄为主,TACI亚型患者责任病灶侧头颈部责任动脉的重度狭窄或闭塞发生率明显高于其他三个亚型组(P<0.05)。OCSP分型各亚型脑梗死患者责任病灶侧头颈部责任动脉中,以颅内外动脉串联狭窄或闭塞为主,其中,PACI和POCI亚型的发生率最高,高于TACI亚型及LACI亚型(P<0.05)。结论 脑梗死患者责任病灶侧头颈部动脉狭窄、狭窄程度和狭窄部位与OCSP分型各亚型有关,对急性脑梗死患者行256层螺旋CT头颈部CTA检查,可明确脑血管狭窄、狭窄程度及责任血管。

    Abstract:

    Aim To analyse characateristic of head and neck CTA by 256-slice CT angiography in patients with cerebral infarction of Oxfordshire Community Stroke Project (OCSP) classification,evaluate the relationship between the degree,location of head and neck artery stenosis and the OCSP classification of responsible side in patients with cerebaral infarction. Methods According to the OCSP classification,300 cases of acute cerebral infarction were divided into total anterior circulation infarct (TACI) (37 cases),partial anterior circulation infarcts (PACI) (109 cases),posterior circulation infarct (POCI) (66 cases) and lacunar infarct (LACI) (88 cases),through retrospective analysis of head and neck CTA by 256-slice CT angiography,responsible vessels characteristic were compared in patients of different types. Results The rate of responsible artery stenosis or occlusion was 86.8%,75.3%,88.5% and 86.3% in patients with acute cerebral infarction of TACI,PACI,POCI and LACI subtype.Statistical significance of responsible artery stenosis or occlusion rate between the subtypes was not found(P>0.05).The degree of head and neck responsible vessels stenosis was different between the OCSP classification.The most of patients of TACI was severe or occlusion,mild or moderate stenosis was dominated in PACI and LACI,mild stenosis was dominated in POCI.The incidence of stenosis or occlusion in TACI was higher than other subtype (P<0.05).Tandem stenosis or occlusion of intracranial and extracranial artery were dominated in different subtype of OCSP,especially in PACI and POCI(P<0.05). Conclusion Head and neck responsible vessels stenosis and the degree of stenosis were related to OCSP classification.256-slice CT angiography of head and neck was helpful to determine the cerebrovascular stenosis,the degree of stenosis and the responsibility vessels.

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张晋霞,王 旭,刘 颖,刘 斌,李世英.脑梗死患者牛津郡社区脑卒中项目分型256层螺旋CT头颈部血管成像特点分析[J].中国动脉硬化杂志,2015,23(07):689~692.

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  • 收稿日期:2014-09-11
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  • 在线发布日期: 2015-07-03