Cheng Stephen W K, Ting Albert C W, Wu Lisa L H
Department of Surgery, The University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Eur J Vasc Endovasc Surg. 2002 Dec;24(6):499-504. doi: 10.1053/ejvs.2002.1752.
to investigate the effect of external irradiation on the morphology of atherosclerotic plaques and the intimal-medial thickness of the carotid artery.
a group of 46 patients (16 symptomatic) who had received external irradiation to the head and neck area more than five years previously and developed carotid stenosis exceeding 50%, were evaluated by duplex ultrasound. The carotid artery lumen, intimal-medial complex, and the plaque echogenicity was determined using computer digital image processing methods. Forty-six age and sex matched patients with similar degrees of non-radiation associated carotid stenosis were used as controls.
irradiated stenotic carotid arteries had a greater intimal-medial thickness (0.96 mm vs 0.80 mm, p=0.008) and a narrower lumen (5.5 mm vs 6.6 mm, p<0.001) than the controls. The carotid plaque characteristics (gray-scale median (GSM) and heterogeneity) of the irradiated and control groups did not differ significantly. Symptomatic patients who had received external radiotherapy to the head and neck have a more echolucent plaque (mean GSM of 98) than their asymptomatic counterparts (mean GSM 114, p=0.03). Intimal-medial thickness and carotid lumen was not related to the occurrence of symptoms.
external irradiation to the head and neck area leads to significantly increased thickness of the carotid wall and a corresponding narrowing of the lumen. There seems to be no difference in the plaque characteristics between irradiation-induced and spontaneous carotid atherosclerosis.
研究体外照射对动脉粥样硬化斑块形态及颈动脉内膜中层厚度的影响。
对一组46例患者（16例有症状）进行评估，这些患者在五年多以前接受过头颈部区域的体外照射，且出现了超过50%的颈动脉狭窄，通过双功超声进行评估。使用计算机数字图像处理方法确定颈动脉管腔、内膜中层复合体及斑块回声性。46例年龄和性别匹配、具有相似程度的非辐射相关性颈动脉狭窄的患者作为对照。
与对照组相比，接受照射的狭窄颈动脉内膜中层厚度更大（0.96毫米对0.80毫米，p = 0.008），管腔更窄（5.5毫米对6.6毫米，p < 0.001）。照射组和对照组的颈动脉斑块特征（灰度中位数（GSM）和异质性）无显著差异。接受过头颈部体外放疗的有症状患者的斑块比无症状患者的斑块回声更低（平均GSM为98，而无症状患者平均GSM为114，p = 0.03）。内膜中层厚度和颈动脉管腔与症状的发生无关。
头颈部区域的体外照射导致颈动脉壁厚度显著增加及相应的管腔狭窄。照射诱导的颈动脉粥样硬化与自发性颈动脉粥样硬化之间的斑块特征似乎没有差异。
