MDCT血管造影术预示脑卒中危险

根据一项最新研究，多重探头计算机断层扫描血管造影能够帮助鉴别出患脑卒中危险较高的颈动脉狭窄患者。检查结果能够帮助确定需要接受手术治疗或者采用创伤性较小治疗方法的患者。

这项研究结果发表在2005年1月《美国X线学期刊》，研究了31例颈动脉狭窄超过60％的患者：18例有颈动脉疾病的症状，包括暂时性或者永久性神经功能障碍；13例没有脑卒中相关症状的疾病史。所有患者都接受了多重探头计算机断层扫描血管造影检查，检测了颈动脉斑块的密度。维吉利亚大学保健系统Kiran R.Nandalur医生说：“我们发现有钙化斑块患者出现症状的可能比非钙化斑块患者小了21倍。”

现在，美国心脏学会建议颈动脉狭窄超过60％的患者接受手术治疗，该机构开展此项手术的并发症较少。但是，Nandalur医生说：“我们的研究提示：没有症状和钙化斑块的患者可以采用创伤性较小的治疗方法，或者只使用药物治疗。但是需要开展大规模前瞻性研究来证实这些研究结果。”

Nandular医生观察到这些现象支持这样的论断：即脑卒中的风险不仅与斑块类型而且与斑块数量相关。

MDCT Angiography Shows Stroke Risk
 
Multiple detector computed tomography (MDCT) angiography can help assess which patients with narrowed carotid arteries are at a greater risk of having a stroke, according to a new study. The results could help determine which patients will require surgery and which can be treated with less invasive techniques.

The study, published in the January 2005 issue of the American Journal of Roentgenology, assessed 31 patients who had greater than 60% carotid artery stenosis--18 had symptoms of carotid artery disease, including transient or permanent episodes of neurologic dysfunction, whereas 13 had no history of stroke-related symptoms. All patients underwent MDCT angiography, and the density of the plaque in the carotid artery was determined. “We found that patients with calcified plaques were 21 times less likely to have symptoms than those with noncalcified plaques,” said Kiran R. Nandalur, M.D., from the University of Virginia Health System (Charlottesville, VA, USA).

At present, the American Heart Association recommends surgery for patients with carotid artery stenosis greater than 60%, given that the institution performing the procedure is associated with low complications. However, said Dr. Nandalur, “our study suggests that patients who have no symptoms and calcified plaques could potentially be treated less aggressively, possibly with just medicine, although larger prospective studies need to be done to confirm these results.”

Dr. Nandular observed that this evidence supports the emerging findings that the risk of stroke is dependent on the plaque type as well as the plaque amount.