弦弧比法评估颈部血管颅外段迂曲的初步探讨  

String arc ratio method to evaluate the tortuosity of extracranial cervical vessels

作　　者：李江[1] 李勍[1] 艾山江[1] 孟学刚[1] 党辉[1] 何晓燕[1] 地力木拉提[1] 朱沂[1] 李红燕[1] 

机构地区：[1]新疆维吾尔自治区人民医院神经内科,乌鲁木齐830001

出　　处：《中国医学前沿杂志（电子版）》2016年第10期68-71,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：新疆维吾尔自治区卫生厅青年科技人才专项科研项目(2009Y15)

摘　　要：目的探索评估颈部血管颅外段迂曲程度的新方法(弦弧比法),为进一步研究颈部血管迂曲的危险因素及其与脑血管病之间的关系提供参考依据。方法收集2011年1月至2015年7月于本院神经内科行全脑血管造影的163例患者的影像资料。采用血管造影机自带软件精确测量患者双侧颈内动脉起始部至颈内动脉C2段末端的实际长度;测量双侧椎动脉起始部至V2末端的实际长度。将起点与终点间的直线距离定义为理论长度,二者比值(弦弧比=实际长度/理论长度)定义为迂曲指数。以Metz法对造影图像进行再评估,按血管形态分为非迂曲、"C"形迂曲、折曲、盘曲,比较两组患者迂曲血管与非迂曲血管的迂曲指数。结果共测量592支血管的实际长度及理论长度,其中非迂曲血管302支(51.01%),"C"形迂曲血管205支(34.63%),折曲血管64支(10.81%),盘曲血管21支(3.55%)。非迂曲颈动脉迂曲指数为1.109±0.073,迂曲颈动脉迂曲指数为1.300±0.142,二者比较差异具有显著性(P<0.05)。非迂曲椎动脉迂曲指数为1.045±0.040,迂曲椎动脉迂曲指数为1.134±0.077,二者比较差异具有显著性(P<0.05)。结论采用弦弧比法评估血管迂曲程度理论上可行,优势在于其可定量分析评估血管迂曲程度,更加客观,易于操作,可重复性强。Objective To explore a new method （string arc ratio method） to evaluate the tortuous degree of the neck vascular, which may help to the further study of the risk factors of neck vascular tortuosity and help to reveal the relationship between vascular circuity and cerebrovascular disease. Method Imaging data of 163 patients who underwent digital subtraction angiography in our hospital from January 2011 to July 2015 were collected. Measured the actual length of bilateral starting segment of internal carotid artery to C2 segment of internal carotid artery and the length of bilateral starting segment of vertebral artery to V2 segment by software which came with angiography machine, accurately. Linear distance between the starting point and the end point is defined as the theoretical length, and the ratio （actual length/theoretical length） is defined as circuity index. The pictures were re-evaluated by two doctors with at least vice-senior title according to the method of Metz, and were divided into four kinds of tortuous （non-tortuos, ＂C＂ shape tortuosity, flex and coiling,） according to the morphology of vessels. Compared the tortuosity index of tortuous vessels and non-tortuous vessels. Result A total of 163 patients with 592 vessels were measured, including non tortuous 302 vessels （51.01%）, ＂C＂ shape 205 vessels （34.63%）, flex 64 blood vessels （10.81%）, coiling 21 blood vessels （3.55%）. Obvious difference were observed in tortuosity index of non-tortuous carotid artery and tortuous carotid [（1.109±0.073） ： （1.300±0.142）, P 〈 0.05]; there was also significant difference in the tortuosity index of vertebral artery with or without tortuosity [（1.045±0.040） ： （1.134±0.077）, P 〈 0.05]. Conclusion Arc chord ratio method in evaluation of vascular tortuosity degree, which make quantitative analysis evaluation of vascular tortuosity degree possible, is theoretical feasible, with additional benefits of easier operation and higher repeatability.

关 键 词：弦弧比法 Metz法 迂曲指数 脑血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]