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颈动脉分叉角几何形态与颈内动脉粥样硬化斑块形成的CTA相关性分析

作者:何汇忱 周仕恩

所属单位:民航总医院影像中心(北京 100123)

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摘要

目的 利用多层螺旋CT血管成像 (MSCTA)评价颈动脉分叉角几何形态与颈 内动脉粥样硬化斑块存在的相关性。方法 回顾性分析2012-2013年在我院行颈动脉 CT血管造影的58例受检者。利用GEAW4.4 工作站进行图像分析,观察颈动脉分叉角 类型,测量颈内动脉分叉角、颈外动脉分 叉角、颈总动脉分叉角、颈内动脉起始 部斑块厚度。根据双侧颈内动脉斑块的有 无对颈内动脉分叉角、颈外动脉分叉角、 颈总动脉分叉角、颈内动脉分叉角标准化 指数的大小及颈动脉分叉角类型分别进 行分组,采用 SPSS16.0 软件进行配对 T检验及卡方检查,P<0.05为有统计学 意义。结果 颈内动脉分叉角分组中,T值 为-1.244(P=0.219);颈外动脉分叉角分 组中,T值为-0.027(P=0.978);颈总动脉 分叉角分组中,T值为-0.186(P=0.853); 颈内动脉分叉角标准化指数分组中, T值为-1.379(P=0.173)。对颈动脉角 分叉类型分组进行卡方检验,χ2 值为 0.919(P=0.632)。各组检验P值均大于 0.05。结论 颈动脉分叉角几何形态与颈 内动脉起始部斑块的形成无明显关联。

Objective To evaluate the correlation between the geometric shape of the carotid bifurcation angle and the existence of the internal carotid atherosclerotic plaque on multi-slice spiral CT angiography (MSCTA). Methods MSCTA images of fiftyeight subjects from 2012~2013 were analyzed retrospectively, in which images were processed and analyzed with the GE AW4.4 workstation. The geometric shape of the carotid bifurcation angle, the common carotid bifurcation angle (CCBA), the internal carotid bifurcation angle (ICBA) and external carotid bifurcation angle (ECBA), the presence or absence of plaque of the internal carotid and the thickness of plaque at the initial region of the internal carotid artery(ICA), were determined. The geometric shape of the carotid bifurcation angle, CCBA, ICBA, ECBA and normalized ICBA indexes were grouped by the presence or absence of plaque of the internal carotid. The paired T-test or Chi-Square Tests were performed with SPSS version 16.0. Statistical significance was set at P<0.05. Results There was no difference in the presence or absence of plaque of the internal carotid from each aspect between the ICBA and the presence or absence of plaque of the internal carotid (T=-1.244, P=0.219), the ECBA and the plaque (T=- 0.027, p=0.987), the CCBA and the presence or absence of plaque of the internal carotid (T=-0.186, P=0.853), and the normalized internal carotid bifurcation angle index and the presence or absence of plaque of the internal carotid (T=-1.379, P=0.173), the geometric shape of the carotid bifurcation angle and the presence or absence of plaque of the internal carotid (χ2 =0.919, P=0.632). Conclusion The variability between the geometric shape of the carotid bifurcation angle is not associated with the presence or absence of plaque of the internal carotid.

【关键词】颈动脉分叉角;粥样硬化斑 块;血管造影;体层摄影 术;X线计算机

【中图分类号】R455.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.04.012

前言

中国每年新发脑卒中患者约200万人,其中70%~80%的脑卒中患者 因为残疾不能独立生活[1]。颈动脉粥样硬化继发血栓形成及栓子脱落 是引起短暂性脑缺血发作、脑卒中的主要原因。不同个体间由于性 别、年龄、血压、血脂、血糖等危险因素不同,颈动脉动脉粥样硬化 斑块分布及严重程度也不同,但对于同一个体,两侧颈动脉粥样硬化 斑块严重程度也往往不一致。本研究通过回顾性分析一组经多层螺旋 CT颈动脉血管成像检查的病例,探讨颈动脉分叉角几何形态对同一个 体颈内动脉起始部粥样硬化斑块形成的影响。