CTA对颈动脉分叉处解剖形态与粥样硬化相关性分析  

Analysis of the relationship between atherosclerosis and anatomical characteristics of carotid bifurcation in Chinese population based on CTA

作　　者：席雨萌 范真真 袁开林 董志辉[2] XI Yumeng;FAN Zhenzhen;YUAN Kailin;DONG Zhihui(Division of Graduate,Xinxiang Medical University,Xinxiang 453003,China;Department of Radiology,Luoyang Central Hospital,Luoyang 471000,China)

机构地区：[1]新乡医学院研究生院,河南新乡453003 [2]河南省洛阳市中心医院影像科,河南洛阳471000

出　　处：《医学影像学杂志》2024年第7期13-17,共5页Journal of Medical Imaging

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20230829)。

摘　　要：目的 探讨基于CT血管成像(computed tomography angiography,CTA)技术在颈动脉分叉处解剖形态特点与该部位粥样硬化斑块形成之间的关系。方法 选取行颈部或头颈部CTA检查的118例(236侧血管)患者的影像学及临床资料。分析颈动脉分叉处斑块形成的危险因素。根据颈动脉分叉处是否存在斑块将118例患者分为斑块组与无斑块组。CTA用于记录颈动脉分叉的TF-AHCB分型,测量颈动脉的几何参数(包括不同位置的管腔面积),监测斑块的性质(软斑块、钙化斑块和混合斑块)和斑块的位置,并分析颈动脉分叉的形态与动脉粥样硬化斑块形成和发展之间的关系。结果 118例患者的236侧血管中,斑块组111侧,无斑块组125侧。在年龄、冠心病史与卒中史方面,斑块组与无斑块组之间差异具有统计学意义(P<0.05)。与无斑块组相比,斑块组颈内动脉膨大处(internal carotid sinus, ICS)血管截面面积更大(51.85 mm^(2) vs 47.54 mm^(2)),而两组间其他颈动脉几何参数差异无统计学意义(P>0.05)。B型组在颈内动脉近端、远端及ICS血管面积高于A型组及C型组。结论 CTA及其后处理技术能够有效测量并评估颈动脉分叉处的几何形态,深入分析颈动脉分叉血管与斑块形成之间的关联性,为缺血性脑卒中的临床工作提供有力帮助。Objective To investigate the relationship between the anatomical and morphological characteristics of the carotid bifurcation and the formation of atherosclerotic plaques in this areaon computed tomography angiography(CTA).Methods Im‐aging and clinical data of 118 patients who underwent carotid or head and neck CTA were selected.Risk factors for plaque forma‐tion in the carotid bifurcation were analyzed.The cases were divided into plaque and no-plaque groups according to the presence or absence of plaque in the carotid bifurcation.CTA was used to document TF-AHCB staging of the carotid bifurcation,to mea‐sure geometric parameters of the carotid artery(including lumen area at different locations),to monitor the nature of the plaque(soft,calcified and mixed plaques)and the location of the plaque,and to analyze the relationship between the morphology of the carotid bifurcation and atherosclerotic plaque formation and development.Results Of the 236 vessels in 118 patients,111 were in the plaque group and 125 in the no-plaque group.There were statistically significant differences in age,history of coronary heart disease,and stroke between the plaque and non-plaque groups(P<0.05).Compared with the non-plaque group,the cross-sectional area of the internal carotid artery at the dilated site(internal carotid sinus,ICS)was larger in the plaque group(51.85 mm^(2) vs 47.54 mm^(2)),while,other geometric features showed no difference between two groups.The Type B group had higher ves‐sel areas at the proximal,distal,and dilated parts of the internal carotid artery than the Type A and Type C groups.Conclusion Multi-slice spiral CTA and its post-processing technology can effectively measure and evaluate carotid bifurcation geometry,and deeply investigate the relationship between carotid bifurcation and plaque formation,which can provide a powerful help for the clinical work of ischemic stroke.

关 键 词：颈动脉分叉 解剖 动脉粥样硬化 体层摄影术 X线计算机 血管造影 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]