【摘要】 目的探讨CT平扫检测短暂性脑缺血发作(TIA)患者颈内动脉虹吸部钙化与MSCTA显示颈动脉分叉处狭窄的关系。方法对84例同时行CT平扫及MSCTA检查的TIA患者影像资料进行回顾性分析,根据MSCTA图将颈动脉分叉处狭窄分为无狭窄、轻度狭窄(0-49%)、中度狭窄(50-69%)、重度狭窄(70-99%)、闭塞(100%)五种;根据平扫CT图将颈内动脉虹吸部钙化分为0-4级,0级为无钙化,1级为点状钙化,2级为(弧形钙化占管壁的范围)<90°,3级90-270°,4级>270°,0-1级为低级别钙化,2-4级为高级别钙化,分析虹吸部钙化、钙化形态与颈动脉分叉处狭窄的关系。结果 84例患者中,左侧、右侧及混合组狭窄发生率为43%、43%及58%;颈动脉虹吸部有钙化且钙化范围越大高度提示颈动脉分叉处狭窄,诊断具有较高的敏感性(73%)和特异性(71%);虹吸部没有钙化的颈动脉较少发生中度或重度的狭窄,即狭窄程度超过50%(诊断特异度100%);虹吸部钙化无法有效预测颈动脉中度和重度狭窄,诊断敏感性为5.8%。结论虹吸部钙化及钙化范围可以作为TIA患者预测颈动脉分叉处狭窄的两项指标。更多还原

【Abstract】 Objective To evaluate the relation between carotid siphon calcification with the presence of TIA on non-enhanced CT images and carotid artery bifurcation stenosis(CABS) on MSCTA images. Methods This IRB-waived retrospective study included 84 consecutive patients suspected of TIA who underwent non-enhanced CT and MSCTA of the head and neck. CABS was rated on CTA as not present or present with non-significant(0-40%), moderate(50-69%), significant(70-99%) and occlusion(100%). And carotid siphon calcification was classified into 5 grades on non-enhanced CT images including grade 0(no calcification), grade 1(small spotty foci of calcification), grade 2(a single calcification occupying <90°), grade 3(90-270°), grade 4(>270°). Furthermore, grade 0-1 were defined as low grade calcification, and grade 2-4 were defined as high grade calcification. Presence, shape of carotid siphon calcification were analyzed the relationship with CABS. Resultsesults The presence of CABS were as follows: left side, 43%; right side, 43%; bilateral sides, 58%. The presence of carotid siphon calcification and bigger extent of calcification resulted in odds ratios for having CABS, with a high sensibility(73%) and specificity(71%). Absence of calcification in carotid artery siphon has a high negative predictive value for CABS in patients(specificity of diagnosis=100%). However, siphon calcification is not a reliable indicator of moderate and significant carotid artery stenosis(sensibility of diagnosis=5.8%). Conclusion Presence and extent of calcification in carotid artery siphon can be indicators of CABS in the patients with TIA.更多还原