Application Research Of 16 Segments Of Multislice Computed Tomography Angiography In The Diagnosis Of Carotid Artery Atherosclerotic Plaque

Objective: To analyze 16 segments of multislice computed tomography angiography (16-MSCTA), to explore the clinical value of 16-MSCTA in atherosclerotic sclerosis lesion of internal carotid artery.Methods: Collected from 92 cases of ischemic cerebrovascular disease who underwent 16-MSCTA examination (included 6 cases of cranio-cervical artery stent follow-up patients), imaging of carotid artery reconstruction by 1-3 grade image quality evaluation; Statistics plaque type, distribution and calcification of the situation, in 55 cases, patients who were diagnosed with anterior circulation ischemic attack within 1 week underwent 16-MSCTA and digital subtraction angiography (DSA) examination, in which DSA as a standard measurement, to assess 16-MSCTA diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value of extra-cranial internal carotid artery stenosis.Results: After carotid artery image reconstruction formed with 16-MSCTA, 91.8 % appraisal rate for overall images, initial segment of carotid artery, extra-cranium, and intra-cranium segments'blood vessel display rate is 92.9%, 97.8%, 84.7% respectively. By comparing 16-MSCTA and DSA test results of 55 cases of a total 110 extra-cranial internal carotid pulse within this group, both extra-cranial carotid artery stenosis degree judgement uniformity are 90.9%, kappa 0.875(p<0.001), the 16-MSCTA diagnosis sensitivity, specificity, positive predictive value, negative predictive value, and mild degree stenosis in all levels of extra-cranial internal carotid artery stenosis are 88.89%,93.33%,84.21%,95.45%;medium:95.83%,95.45%,88.46%,98.43%;severe degree:100%,98.90%,93.75%,100%, occlusion: 100%,100%,100%,100%. Among 92 cases, 74 cases of patients, who had done 16-MSCTA, were detected with 175 plaques, of these, 11 in aortic arch, 33 in common carotid artery, 92 in the bifurcation of carotid artery, 25 in internal carotid artery, and 14 in external carotid artery. The probability of artery plaque and calcification occurance in the bifurcation of carotid artery is the highest. 6 cases of cranio-cervical artery stent follow-up patients, 16-MSCTA is better in showing condition of the stent, to determine the patency of the cavity.Conclusions: 1. 16-MSCTA to Carotid Artery main body's image quality is higher, but each part is different, in between compare to the extra-cranial part's image quality is better. 2. At the determination of extra-cranial Internal Carotid Artery stenosis degree, comparing between 16-MSCTA and DSA, not only the consistency is very high, but also the efficiency in diagnosing the severity and the increase rate of the stenosis, so it can be used at extra-cranial internal carotid artery stenosis condition. 3. 16-MSCTA examination can find the distribution of the atherosclerotic plaque in bigger scope, and also in determination of progressing substances, from my observation: the difference between Carotid Artery's atherosclerotic plaque distribution site and calcification remain as a prominent significance, limited until carotid artery bifurcation examination can be missed diagnosis as high risk plaque. 4. 16-MSCTA can be used for the initial assessment of the intracavity post extra-cranial Artery stent operation, as to provide a new route for post stent operation follow-up.