基于头颈CTA评估餐巾环征斑块与缺血性脑卒中的相关性研究  

The Study of the Correlation Between Napkin Ring Sign Plaque and Ischemic Stroke Based on Cervicocerebral Computed Tomography Angiography

作　　者：吴静萍 孟晓 卫勃 崔芳 孟庆林 张帆 WU Jingping;MECN Xiao;WEI Bo(Department of Radiology,Hainan Hospital of Chinese PLA General Hospital,Sanya,Hainan Province 572013,P.R.China)

机构地区：[1]中国人民解放军总医院海南医院放射诊断科,三亚572013 [2]中国人民解放军总医院海南医院普通外科,三亚572013 [3]中国人民解放军总医院海南医院神经内科,三亚572013 [4]三亚学院,三亚572000 [5]南方医科大学第二临床医学院,广州510515

出　　处：《临床放射学杂志》2024年第7期1089-1094,共6页Journal of Clinical Radiology

基　　金：海南省重点科研项目社会发展科技专项资助项目(编号:ZDYF2019169)。

摘　　要：目的基于头颈CT血管造影(CTA)研究“餐巾环征”(NRS)斑块与急性缺血性脑卒中的关系。方法纳入接受头颈动脉CTA检查并发现NRS斑块的患者共225例,其中发生急性缺血性脑卒中患者113例,未发生脑缺血事件者112例,比较NRS斑块在两组中的频率和分布特征,采用Logistic回归筛选缺血性脑卒中发生的危险因素。结果113例脑卒中患者发现214个NRS斑块,112例对照组患者发现156个NRS斑块,卒中组患者的平均斑块数量及面积大于对照组[1.89±1.13 vs.1.39±0.61,P=0.001;(23.96±23.02)mm^(2)vs.(11.12±8.62)mm^(2),P<0.001],缺血性脑卒中患者卒中责任血管的斑块数量显著多于对侧[1.50±0.86 vs.0.39±0.65,P<0.001;(11.64±8.53)mm^(2)vs.(4.64±9.56)mm^(2),P<0.001]。两组人群管腔狭窄程度及狭窄部位的分布差异无统计学意义。NRS斑块的分布在两组人群中以颈总动脉最多见。Logistic回归分析显示NRS斑块数量是缺血性脑卒中患者的独立危险因素。结论采用头颈CTA评估NRS斑块可作为脑缺血事件预防和诊治的重要靶点。Objective To investigate the relationship between plaque with napkin-ring sign(NRS)and acute ischemic stroke(AIS)based on cervicocerebral CTA(computed tomography angiography).Methods A total of 225 patients who underwent cervicocerebral CTA and found NRS plaques between January 2019 and May 2023 were included,which were divided into two groups(113 patients with AIS and 112 individuals without AIS).The frequency and distribution of plaques with NRS in two groups were compared.Logistic regression analysis was used to screen the risk factor of ischemic stroke.Results The mean number and area of NRS plaques in the AIS group were greater than those in the control group[1.89±1.13 vs.1.39±0.61,P=0.001;(23.96±23.02)mm^(2) vs.(11.12±8.62)mm^(2),P<0.001],as well as in the ipsilateral culprit vessel and contralateral side to AIS[1.50±0.86 vs.0.39±0.65,P<0.001;(11.64±8.53)mm^(2) vs.(4.64±9.56)mm^(2),P<0.001].There were no differences in the degree and distribution of luminal stenosis between two groups.NRS plaques were most commonly found in the common carotid arteries in both groups.Logistic regression analysis showed that the number of NRS plaques was an independent risk factor for AIS.Conclusion The assessment of NRS plaques utilizing cervicocerebral CTA could be an essential target for the prevention and management of ischemic events.

关 键 词：急性缺血性脑卒中 餐巾环征 CT血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]