根據一項最新研究，多重探頭計算機斷層掃描血管造影能夠幫助鑒別出患腦卒中危險較高的頸動脈狹窄患者。檢查結果能夠幫助確定需要接受手術治療或者采用創傷性較小治療方法的患者。

這項研究結果發表在2005年1月《美國X線學期刊》，研究了31例頸動脈狹窄超過60％的患者：18例有頸動脈疾病的癥狀，包括暫時性或者永久性神經功能障礙；13例沒有腦卒中相關癥狀的疾病史。所有患者都接受了多重探頭計算機斷層掃描血管造影檢查，檢測了頸動脈斑塊的密度。維吉利亞大學保健系統Kiran R.Nandalur醫生說：“我們發現有鈣化斑塊患者出現癥狀的可能比非鈣化斑塊患者小了21倍。”

現在，美國心臟學會建議頸動脈狹窄超過60％的患者接受手術治療，該機構開展此項手術的并發癥較少。但是，Nandalur醫生說：“我們的研究提示：沒有癥狀和鈣化斑塊的患者可以采用創傷性較小的治療方法，或者只使用藥物治療。但是需要開展大規模前瞻性研究來證實這些研究結果。”

Nandular醫生觀察到這些現象支持這樣的論斷：即腦卒中的風險不僅與斑塊類型而且與斑塊數量相關。

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.