颅内外动脉狭窄的测量最详细PPT推荐版
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Angiogram shows anatomic sites of measurement in the carotid artery for calculating percent stenosis for the North American Symptomatic Carotid Endarterectomy Trial (NASCET), European Carotid Surgery Trial (ECST), and Carotid Stenosis Index (CSI) methods.
Figure 1. Angiogram shows anatomic sites of measurement in the carotid artery for calculating percent stenosis for the North American Symptomatic Carotid Endarterectomy Trial (NASCET), European Carotid Surgery Trial (ECST), and Carotid Stenosis Index (CSI) methods. D indicates diameter of internal carotid artery (ICA) stenosis; N, normal ICA diameter used in each method. Note that for CSI the common carotid artery value of N is multiplied by 1.2 to give the predicted outline of the proximal ICA.
CSI
1995年，又有人提出了另一种测量方法， 即颈动脉狭窄指数（Carotid Stenosis Index ，CSI），也是以颈总动脉为分母， 并与NASCET和ECST进行比较。——C.F. Bladin, A.V. Alexandrov, et al. Carotid Stenosis Index，A New Method of Measuring Internal Carotid Artery Stenosis. Stroke. 1995;26:230-234
Note that for CSI the common carotid artery value of N is multiplied by 1. 如：整个基底动脉病变，Dnormal定义为其优势侧椎动脉最远端的无弯曲正常管径直径； Long-Term Outcome After Angioplasty and Stenting for Symptomatic Vertebral Artery Stenosis Compared With Medical Treatment in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS)，A Randomized Trial. CT:
Nቤተ መጻሕፍቲ ባይዱSCET
North American Symptomatic Carotid Endarterectomy Trial, Methods, Patient
Characteristics, and Progress ——North American Symptomatic Carotid Endarterectomy Trial (NASCET) Steering Committee，Stroke 1991;22;711-720 目的：评价症状性颈动脉狭窄的内膜剥脱术的效 果 结论：对于症状性颈动脉狭窄的病人，狭窄程度 在50-99%也是有效的
1998;29:1389-1392 狭窄严重程度=（1-A/V）100%，A=最狭窄处的残余管径，V=病变远端的管壁大致正常的管径，类似于NASCET中的颈动脉狭窄的测 量方法。 ——North American Symptomatic Carotid Endarterectomy Trial (NASCET) Steering Committee，Stroke 1991;22;711-720 MRC European Carotid Surgery Trial(ECST) 狭窄率=[1-(Dstenosis/Dnormal)] ×100% 如果有串联的颅内病变（如同时有椎动脉远端和基底动脉中段），则要分别计算各处狭窄的狭窄率，取其最狭窄的数值为结果。
2 to give the predicted outline of the proximal ICA. 不受钙化、无辐射、肾功要求低
North American Symptomatic Carotid Endarterectomy Trial (NASCET) (the CAVATAS Investigators. North American Symptomatic Carotid Endarterectomy Trial (NASCET) 1： (1-md/C) 100% 目的：评价症状性颈动脉狭窄的内膜剥脱术的效果
检查手段
颈部：
体检
彩超 CT MR DSA
头颅 TCD CTA MRA DSA
体检：
触诊： 听诊：
超声：
彩色超声： 经颅多普勒超声：
CT:
最大密度投影 表面重建 减影重建 曲面重建 断面观察 多种成像结合原始
断层综合分析。
MR:
MRI 高分辨MR MRA
1.容易夸大病变，假阳性。 2.不受钙化、无辐射、肾功要求低 3.增强MRA更准确
DSA:
全面、多角度、着眼治疗
观测角度：
腔内显示： TCD CTA MRA DSA
腔内外联合显示： 彩超 增强CT 普通和高分辨ＭＲ
颈动脉狭窄测量
1： (1-md/C) 100% 2： (1-md/B) 100% 3： (1-md/A) 100%
1. North American Symptomatic Carotid Endarterectomy Trial (NASCET) 2. MRC European Carotid Surgery Trial(ECST) 3. Common carotid method（CC）
Figure 1. Angiogram shows anatomic sites of measurement in the carotid artery for calculating percent stenosis for the North American Symptomatic Carotid Endarterectomy Trial (NASCET), European Carotid Surgery Trial (ECST), and Carotid Stenosis Index (CSI) methods. D indicates diameter of internal carotid artery (ICA) stenosis; N, normal ICA diameter used in each method. Note that for CSI the common carotid artery value of N is multiplied by 1.2 to give the predicted outline of the proximal ICA.
CSI
1995年，又有人提出了另一种测量方法， 即颈动脉狭窄指数（Carotid Stenosis Index ，CSI），也是以颈总动脉为分母， 并与NASCET和ECST进行比较。——C.F. Bladin, A.V. Alexandrov, et al. Carotid Stenosis Index，A New Method of Measuring Internal Carotid Artery Stenosis. Stroke. 1995;26:230-234
Note that for CSI the common carotid artery value of N is multiplied by 1. 如：整个基底动脉病变，Dnormal定义为其优势侧椎动脉最远端的无弯曲正常管径直径； Long-Term Outcome After Angioplasty and Stenting for Symptomatic Vertebral Artery Stenosis Compared With Medical Treatment in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS)，A Randomized Trial. CT:
Nቤተ መጻሕፍቲ ባይዱSCET
North American Symptomatic Carotid Endarterectomy Trial, Methods, Patient
Characteristics, and Progress ——North American Symptomatic Carotid Endarterectomy Trial (NASCET) Steering Committee，Stroke 1991;22;711-720 目的：评价症状性颈动脉狭窄的内膜剥脱术的效 果 结论：对于症状性颈动脉狭窄的病人，狭窄程度 在50-99%也是有效的
1998;29:1389-1392 狭窄严重程度=（1-A/V）100%，A=最狭窄处的残余管径，V=病变远端的管壁大致正常的管径，类似于NASCET中的颈动脉狭窄的测 量方法。 ——North American Symptomatic Carotid Endarterectomy Trial (NASCET) Steering Committee，Stroke 1991;22;711-720 MRC European Carotid Surgery Trial(ECST) 狭窄率=[1-(Dstenosis/Dnormal)] ×100% 如果有串联的颅内病变（如同时有椎动脉远端和基底动脉中段），则要分别计算各处狭窄的狭窄率，取其最狭窄的数值为结果。
2 to give the predicted outline of the proximal ICA. 不受钙化、无辐射、肾功要求低
North American Symptomatic Carotid Endarterectomy Trial (NASCET) (the CAVATAS Investigators. North American Symptomatic Carotid Endarterectomy Trial (NASCET) 1： (1-md/C) 100% 目的：评价症状性颈动脉狭窄的内膜剥脱术的效果
检查手段
颈部：
体检
彩超 CT MR DSA
头颅 TCD CTA MRA DSA
体检：
触诊： 听诊：
超声：
彩色超声： 经颅多普勒超声：
CT:
最大密度投影 表面重建 减影重建 曲面重建 断面观察 多种成像结合原始
断层综合分析。
MR:
MRI 高分辨MR MRA
1.容易夸大病变，假阳性。 2.不受钙化、无辐射、肾功要求低 3.增强MRA更准确
DSA:
全面、多角度、着眼治疗
观测角度：
腔内显示： TCD CTA MRA DSA
腔内外联合显示： 彩超 增强CT 普通和高分辨ＭＲ
颈动脉狭窄测量
1： (1-md/C) 100% 2： (1-md/B) 100% 3： (1-md/A) 100%
1. North American Symptomatic Carotid Endarterectomy Trial (NASCET) 2. MRC European Carotid Surgery Trial(ECST) 3. Common carotid method（CC）