目的 研究128层螺旋CT头颈部 血管成像评估急性脑梗死患者颈动脉狭 窄的临床价值。方法 选取我院2010年3 月至2013年3月急性脑梗死患者58例为观 察组，同时选取同期就诊的非急性脑梗 死患者58例为对照组，两组均采用128层 螺旋CT头颈部血管成像技术进行诊断。根 据检测所获得的图像比较两组颈动脉狭窄 程度和双侧颈动脉斑块的分布情况。结 果 观察组二次诊断81.03%的患者出现颈 动脉狭窄，较对照组48.28%显著较高(P ＜0.05)，其中轻度狭窄44.83%、中度狭 窄24.14%，与对照组的25.86%、10.34比 较显著较高(P＜0.05)；观察组斑块总检 出率为71.78%较对照组的54.45%均显著较 高(P＜0.05)。结论 临床上应用128层螺 旋CT头颈部血管成像技术可更有效的评估 急性脑梗死患者劲动脉狭窄情况，其双侧 颈动脉斑块检出率更高，对诊断急性脑梗 死有重要作用，有应用推广价值。

Objective To study the clinical value of 128 slice spiral CT angiography of head and neck in evaluation of carotid artery stenosis in patients with acute cerebral infarction. Methods Fifty-eight patients with acute cerebral infarction admitted in our hospital from March 2010 to March 2013 were chosen as the observation group. Another 58 patients without acute cerebral infarction who were treated during the same period were included in the control group. Both of the two groups were performed 128 slice spiral CT angiography of head and neck. According to the images obtained, the degree of carotid artery stenosis and distribution of bilateral carotid artery plaques were compared between the two groups. Results The repeat diagnosis found that 81.03% of the patients in the observation group with carotid artery stenosis which was significantly higher than 48.28% in the control group (P<0.05). The proportions of mild stenosis and moderate stenosis (44.83%, 24.14%) were significantly higher than those in the control group (25.86%, 10.34%) (P<0.05). The total detection rate of plaque in the observation group (71.78%) was significantly higher than that in the control group (54.45%) (P<0.05). Conclusion In clinic, the application of 128 slice spiral CT angiography of head and neck can evaluate carotid stenosis in patients with acute cerebral infarction more effectively. The detection rate in bilateral carotid artery plaque is higher. It plays an important role in the diagnosis of acute cerebral infarction. It is of application and promotion value.