中国卒中杂志2019，Vol.14Issue(7)：671-677,7.DOI:10.3969/j.issn.1673-5765.2019.07.008
急性颈内动脉系统脑梗死患者颈内动脉角与动脉粥样硬化斑块形态关系的研究
Relationship between Internal Carotid Artery Angle and Plaque Morphology in Patients with Acute Anterior Circulation Infarction
摘要
Abstract
Objective To investigate the relationship between internal carotid artery angle (ICAA) and internal carotid artery (ICA) plaque morphology in patients with acute anterior circulation infarction using high resolution magnetic resonance imaging (HR-MRI). Methods Patients with acute anterior circulation infarction admitted to Beijing Tian Tan Hospital from November 2011 to June 2012 were enrolled in this study. All patients underwent HR-MRI examination to obtain ICAA and plaque morphology data. According to the median of ICAA, all patients were divided into ICAA ≥35° and <35° groups, and the amounts and characteristics of carotid atherosclerotic plaques between the two groups were compared. Multi-factor logistic regression analysis was performed to analyze the influencing factors of bilateral ICA plaques morphology. Results A total of 162 ICA images from 86 patients were included in the final analysis, with 78 vessels in ICAA ≥35° group and 84 vessels in ICAA <35° group. The detection rate of ICA plaques [92.3% (72/78) vs 56.0% (47/84), P<0.01] and vulnerable plaques [43.6% (34/78) vs 15.5% (13/84), P=0.03] in ICAA≥35° group were both higher than that in ICAA<35° group, with statistical difference. The detection rate of lipid-rich necrotic core plaques [75.6% (59/78) vs 36.9% (31/84), P<0.01] and intraplaque hemorrhage [26.9% (21/78) vs 11.9% (10/84), P=0.02] were higher in ICAA ≥35° group than that in ICAA <35° group. Linear regression analysis showed that age was an independent risk factor of plaque calcification volume on the left side ( B 0.35, 95% CI 0.21-1.65, P=0.01) and intra-plaque hemorrhage volume on the right side ( B 0.34, 95% CI 0.30-2.32, P=0.01), and the non-plane angle of ICAA was an independent risk factor of lipid-rich necrotic core volume in the plaques on the left side ( B 0.37, 95% CI 1.23-7.33, P=0.01), and the non-plane angle of external carotid artery was a risk factor of plaque calcification volume on the right side (B 0.33, 95% CI 0.20-2.07, P=0.02). Conclusions With the increasing of ICA angle, the amount of plaques as well as vulnerable plaques increased. ICAA was associated with the components and amount of carotid plaques, while it was not an independent risk factor for carotid atherosclerosis.关键词
脑梗死/高分辨率磁共振成像/颈动脉角Key words
Cerebral infarction/High resolution magnetic resonance imaging/Carotid artery angle引用本文复制引用
王琳,王晶,申园,龚浠平,刘艳芳..急性颈内动脉系统脑梗死患者颈内动脉角与动脉粥样硬化斑块形态关系的研究[J].中国卒中杂志,2019,14(7):671-677,7.基金项目
北京市科学技术委员会2011年度科技计划重大项目(D111107003111007) （D111107003111007）
