目的 探讨256层螺旋CTA对颈动 脉狭窄及颈动脉粥样硬化斑块形态的评 估价值。方法 82例拟诊为颈动脉狭窄 患者，均行256排螺旋CT血管造影(CTA) 检查，以数字减影血管造影(DSA)为“金 标准”，了解CTA诊断颈动脉狭窄情况 及斑块形态。结果 以DSA检查为“金标 准”，CTA诊断颈动脉粥样硬化的准确率 为93.90%，敏感性为94.20%，特异性为 92.31%；CTA诊断颈动脉狭窄程度的准确 率为92.68%，敏感性为93.93%，特异性为 90.35%。除7例闭塞外，共发现107个颈动 脉粥样硬化斑块，其中64.49%光滑斑块， 25.23%不规则斑块，10.28%溃疡斑块。结 论 256层螺旋CTA不仅可准确判断颈动脉 狭窄程度，还可反映颈动脉粥样硬化斑块 形态，能为临床诊疗提供客观依据。

Objective To evaluate the value of 256 slice spiral CTA in the evaluation of carotid artery stenosis and shape of carotid atherosclerotic plaque. Methods 82 cases patients with carotid artery stenosis underwent 256 slice spiral CT angiography (CTA). Digital subtraction angiography (DSA) was taken as the golden standard to understand CTA in the diagnosis of carotid stenosis and shape of plaque. Results With DSA as the golden standard, the accuracy, sensitivity and specificity of CTA in diagnosis of carotid atherosclerosis were 93.90%, 94.20% and 92.31%, respectively while those of CTA were 92.68%, 93.93% and 90.35% respectively. Except for 7 cases with occlusion, 107 carotid atherosclerotic plaques were found of which 64.49% were smooth, 25.23% irregular and 10.28% ulcer plaques. Conclusion 256 slice spiral CTA not only can accurately determine the degree of carotid stenosis, but also can reflect the shape of carotid atherosclerotic plaques, which can provide an objective basis for clinical diagnosis and treatment.