双源CT分析颈内动脉迂曲和斑块负荷对脑梗死发生率的影响  

Effect of internal carotid artery tortuosity and plaque burden by dual-source CT analysis on incidence of cerebral infarction

作　　者：蒋嫚文 王云[3] 马喜娟[4] 顾艳 师毅冰[4] Jiang Manwen;Wang Yun;Ma Xijuan;Gu Yan;Shi Yibing(Imaging Department,Lianyungang Hospital Affiliated to Xuzhou Medical University,Lianyungang 222000,China;Electrocardiogram Department,Lianyungang Municipal Oriental Hospital,Lianyungang 222000,China;Department of Hepatobiliary and Pancreatic Surgery,Xuzhou Central Hospital,Xuzhou 221000,China;Imaging Department,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属连云港医院影像科,连云港222002 [2]连云港市立东方医院心电图室,连云港222002 [3]徐州市中心医院肝胆胰外科,徐州221000 [4]徐州市中心医院影像科,徐州221000

出　　处：《中国医学装备》2024年第12期50-55,共6页China Medical Equipment

基　　金：江苏省卫生健康委医学科研项目(M2021014)。

摘　　要：目的:通过双源CT分析颈内动脉迂曲程度与斑块负荷之间的相关性,并进一步研究颈内动脉迂曲与脑梗死形成的关系。方法:回顾性选取2021年12月至2022年12月在徐州医科大学附属连云港医院行头颈部CT血管造影(CTA)检查的106例颈内动脉迂曲患者,根据头颅MRI检查结果分为脑梗死组(53例)和无脑梗死组(53例)。比较两组的颈内动脉迂曲相关指标(迂曲指数、血管偏离度、血管迂曲度),斑块特征参数(斑块面积、血管面积、斑块负荷)。采用单因素分析和多因素分析,收集两组患者的年龄、性别、基础病史(如高血压、糖尿病、冠心病等)、生活习惯(如吸烟、饮酒)以及中风史等信息。临床生化检测指标包括甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白、脂蛋白a以及同型半胱氨酸。探索影响斑块负荷和脑梗死的独立危险因素。通过皮尔逊相关分析检查患者颈内动脉迂曲指标与斑块负荷的相关性,以及颈内动脉迂曲与脑梗死形成的关系。通过受试者工作特征(ROC)曲线评估患者各指标对脑梗死的预测能力。结果:颈内动脉迂曲指数、血管偏离度、斑块负荷、斑块面积和颈动脉狭窄程度均与脑梗死呈显著正相关(r=0.310、0.203、0.345、0.320、0.292,P<0.05)。ROC曲线分析显示,迂曲指数和斑块负荷预测脑梗死准确性的ROC曲线下面积(AUC)分别为0.679和0.677;而联合指标(迂曲指数+斑块负荷)预测脑梗死的AUC值为0.806,显著高于单独使用单个指标(95%CI:0.722~0.89,P<0.001)。结论:颈内动脉迂曲患者的迂曲程度、斑块负荷与脑梗死形成之间存在显著相关性。将迂曲指数和斑块负荷结合使用可显著提高脑梗死的预测准确性。Objective:To analyze the correlation between the degree of internal carotid artery tortuosity and plaque burden through dual-source computed tomography(CT),and to further investigate the relationship between the internal carotid artery tortuosity and the formation of cerebral infarction.Methods:A total of 106 patients with internal carotid artery tortuosity,who underwent computed tomography angiography(CTA)examination on head and neck at the First People's Hospital of Lianyungang from December 2021 to December 2022,were retrospectively selected.The patients were divided into a cerebral infarction group and a non-cerebral infarction group based on cranial magnetic resonance imaging(MRI)examination,with 53 cases in each group.The internal carotid artery tortuosity-related indicators(tortuosity index,degree of vascular deviation,vascular tortuosity),and the parameters of plaque characteristic(plaque area,vascular area and plaque burden)between the two groups were compared.Univariate and multivariate analyses were used,and the information of age,gender,history of underlying disease(such as hypertension,diabetes,coronary heart disease,etc.),lifestyle habits(such as smoking,drinking),and stroke history of patients in both groups were collected.Clinical biochemical indicators included triglycerides,total cholesterol,low-density lipoprotein,high-density lipoprotein,lipoprotein a,and homocysteine.Independent risk factors of affecting plaque burden and cerebral infarction were explored.Pearson correlation analysis was used to examine the correlation between the indicators of internal carotid artery tortuosity and plaque burden of the patients,as well as the relationship between the carotid artery tortuosity and the formation of cerebral infarction.The receiver operating characteristic(ROC)curve was used to assess the predictive ability of indicators of patients for cerebral infarction.Results:The index of internal carotid artery tortuosity,degree of vascular deviation,plaque burden,plaque area,and degree of carotid artery

关 键 词：颈内动脉迂曲 斑块负荷 脑梗死 相关性研究 病例对照 双源CT 

分 类 号：R737.33[医药卫生—肿瘤]