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目的探讨短暂性脑缺血发作(TIA)患者颅内外血管病变。方法对45例患者进行头颈64排CT血管造影(CTA)及经颅多普勒(TCD)和颈动脉彩超检查,观察其异常情况。结果 CTA检查45例TIA患者中40例颅内外共116支动脉狭窄或闭塞,总异常率为88.9%,颅内动脉狭窄或闭塞61.1%高于颅外动脉38.9%,颅外动脉狭窄中以颈内动脉(ICA)颅外段狭窄最多44.4%,颅内动脉狭窄中以ICA颅内段狭窄最多32.3%,频发(发作频率≥2/d)及短时程(发作持续时间在1 h以内)患者重度狭窄及闭塞发生率(74.2%)高于非频发组及长时程(发作持续时间≥1 h),均P<0.05,有统计学意义;TCD异常75.6%,占CTA异常的94.4%,TCD血流速度增快85支,较CTA65支多;颈动脉超声检查结果16例颈部动脉狭窄或闭塞,共35支动脉狭窄或闭塞,其中椎动脉狭窄或闭塞7支。彩色多普勒超声检查对颈动脉狭窄或闭塞检出率低于CTA,对椎动脉的狭窄或闭塞检出率远低于CTA。结论 TIA患者颅内外动脉狭窄或闭塞及斑块发生率高,CTA检查显示动脉狭窄或闭塞异常率为88.9%,颅内动脉狭窄或闭塞高于颅外动脉,频发及短时程患者重度狭窄及闭塞发生率高于非频发组,有统计学意义。
Objective To investigate the intracranial and extracranial vascular lesions in patients with transient ischemic attack (TIA). Methods Totally 45 patients underwent 64-slice CT angiography (CTA) and transcranial Doppler (TCD) and carotid ultrasonography to observe the abnormalities. Results CTA examination included 40 cases of intracranial and extracranial arterial stenosis or occlusion in 40 cases of TIA patients with a total abnormality rate of 88.9%, intracranial arterial stenosis or occlusion of 61.1% higher than that of extracranial artery (38.9%), extracranial artery stenosis Intracranial stenosis (ICA) of the extracranial stenosis up to 44.4%, intracranial artery stenosis ICA intracranial stenosis up to 32.3%, frequency (seizure frequency ≥ 2 / d) and short-term (duration of attack within 1 h ) Patients with severe stenosis and occlusion (74.2%) were higher than those in non-frequency group and long-term duration (duration of attack ≥1 h), both P <0.05, with statistical significance; TCD abnormality was 75.6% 94.4%, TCD blood flow increased 85, more than CTA65; carotid ultrasound examination of 16 cases of cervical stenosis or occlusion, a total of 35 artery stenosis or occlusion, in which vertebral artery stenosis or occlusion of seven. Color Doppler ultrasound examination of carotid artery stenosis or occlusion detection rate lower than CTA, the detection rate of stenosis or occlusion of vertebral artery much lower than CTA. Conclusions The intracranial and extracranial arterial stenosis or occlusion and plaque incidence were high in TIA patients. The abnormal rate of stenosis or occlusion of CIA was 88.9% in CIA patients. The stenosis or occlusion of intracranial artery was higher than that of extracranial artery. Severe stenosis in patients with frequent or short-term And the incidence of occlusion was higher than that of non-frequency group, with statistical significance.