颈动脉蹼的CTA征象分析及临床意义
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摘要
目的探讨CT血管造影(CTA)对颈动脉蹼的影像诊断和鉴别价值。方法回顾性分析48例不明原因缺血性脑卒中患者的临床和CTA检查资料,对CTA图像进行多种模式三维后处理,获得15例颈动脉蹼的影像特征并复习相关文献。结果 48例不明原因缺血性脑卒中患者CTA检查,共检出15例颈动脉蹼,斜矢状面三维重组显示颈动脉蹼位于颈动脉球后壁,呈线条状充盈缺损。11例无颈动脉粥样硬化病变者,9例MRI发现新旧不一脑梗死灶,2例MRI未见梗死灶为复发性短暂脑缺血。结论颈动脉蹼在CTA上有特征的影像表现,CTA可明确诊断颈动脉蹼,后者与脑梗死有一定相关性,应予关注。
Objective To investigate the diagnostic and differential value of CT angiography( CTA) in carotid artery webs. Methods The clinical and CTA data of 48 patients with unexplained ischemic stroke were retrospectively analyzed. Three-dimensional post-processing of CTA images was performed in three modes. The imaging features of 15 cases of carotid artery webs were obtained and related literatures were reviewed. Results A total of 15 cases of carotid sputum were detected by CTA in 48 patients with unexplained ischemic stroke. The three-dimensional reconstruction of the oblique sagittal plane showed that the carotid artery was located in the posterior wall of the carotid artery and was filled with lines.Of the 11 patients without carotid atherosclerosis,9 patients with MRI found new and old cerebral infarction; 2 patients with MRI did not see recurrent transient cerebral ischemia. Conclusion Carotid artery spasm has characteristic imaging findings on CTA. CTA can clearly diagnose carotid artery webs. The latter has certain correlation with cerebral infarction and should be paid attention to.
Objective To investigate the diagnostic and differential value of CT angiography( CTA) in carotid artery webs. Methods The clinical and CTA data of 48 patients with unexplained ischemic stroke were retrospectively analyzed. Three-dimensional post-processing of CTA images was performed in three modes. The imaging features of 15 cases of carotid artery webs were obtained and related literatures were reviewed. Results A total of 15 cases of carotid sputum were detected by CTA in 48 patients with unexplained ischemic stroke. The three-dimensional reconstruction of the oblique sagittal plane showed that the carotid artery was located in the posterior wall of the carotid artery and was filled with lines.Of the 11 patients without carotid atherosclerosis,9 patients with MRI found new and old cerebral infarction; 2 patients with MRI did not see recurrent transient cerebral ischemia. Conclusion Carotid artery spasm has characteristic imaging findings on CTA. CTA can clearly diagnose carotid artery webs. The latter has certain correlation with cerebral infarction and should be paid attention to.
引文
1 Choi PM,Singh D,Trivedi A,et al. Carotid webs and recurrent ischemic strokes in the era of CT angiography[J]. AJNR,2015,36:2134-2139.
2 Sajedi PI,Gonzalez JN,Cronin CA,et al. Carotid Bulb Webs as a Cause of“Cryptogenic”Ischemic Stroke[J]. AJNR,2017,38:1399-1404.
3 Boesen ME,Eswaradass PV,Singh D,et al. MR imaging of carotid web[J]. Neuroradiology,2017,59:361-365.
4 Elmokadem AH,Ansari SA,Sangha R,et al. Neurointerventional management of carotid webs associated with recurrent and acute cerebral ischemic syndromes. Interventional neuroradiology[J]. Journal of Peritherapeutic Neuroradiology,Surgical Procedures and Related Neurosciences,2016,22:432-437.
5 Fu W,Crockett A,Low G,et al. Internal Carotid Artery Web:Doppler Ultrasound with CT Angiography correlation[J]. J Radiol Case Rep,2015,9:1-6.
6 Haussen DC,Grossberg JA,Bouslama M,et al. Carotid Web(Intimal Fibromuscular Dysplasia)Has High Stroke Recurrence Risk and Is Amenable to Stenting[J]. Nogueira 《Stroke》,2017,48:3134-3137.
7 Coutinho JM,Derkatch S,Potvin ARJ. Carotid artery web and ischemic stroke:A case-control study[J]. Neurology,2017,88:65-69.
8 Lantos JE,Chazen JL,Gupta A,et al. Appearance at MR Angiography AJNR[J]. American Journal of Neuroradiology January,2016,37:5-6.
2 Sajedi PI,Gonzalez JN,Cronin CA,et al. Carotid Bulb Webs as a Cause of“Cryptogenic”Ischemic Stroke[J]. AJNR,2017,38:1399-1404.
3 Boesen ME,Eswaradass PV,Singh D,et al. MR imaging of carotid web[J]. Neuroradiology,2017,59:361-365.
4 Elmokadem AH,Ansari SA,Sangha R,et al. Neurointerventional management of carotid webs associated with recurrent and acute cerebral ischemic syndromes. Interventional neuroradiology[J]. Journal of Peritherapeutic Neuroradiology,Surgical Procedures and Related Neurosciences,2016,22:432-437.
5 Fu W,Crockett A,Low G,et al. Internal Carotid Artery Web:Doppler Ultrasound with CT Angiography correlation[J]. J Radiol Case Rep,2015,9:1-6.
6 Haussen DC,Grossberg JA,Bouslama M,et al. Carotid Web(Intimal Fibromuscular Dysplasia)Has High Stroke Recurrence Risk and Is Amenable to Stenting[J]. Nogueira 《Stroke》,2017,48:3134-3137.
7 Coutinho JM,Derkatch S,Potvin ARJ. Carotid artery web and ischemic stroke:A case-control study[J]. Neurology,2017,88:65-69.
8 Lantos JE,Chazen JL,Gupta A,et al. Appearance at MR Angiography AJNR[J]. American Journal of Neuroradiology January,2016,37:5-6.