Uwatoko Takeshi, Toyoda Kazunori, Inoue Tooru, Yasumori Kotaro, Hirai Yuko, Makihara Noriko, Fujimoto Shigeru, Ibayashi Setsuro, Iida Mitsuo, Okada Yasushi
Department of Cerebrovascular Disease, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Cerebrovasc Dis. 2007;24(1):20-6. doi: 10.1159/000103112. Epub 2007 May 22.
To determine the underlying conditions that affect the degree of calcification of carotid arterial plaques, measured quantitatively using multidetector row computed tomography (MDCT), and to study the association of carotid calcification with clinical symptomatology.
We measured the calcification volume of stenotic lesions at the carotid bifurcation using MDCT in 84 consecutive patients who were scheduled to undergo carotid revascularization. These results were compared with the clinical and radiological characteristics of the patients.
On MDCT, calcification in the carotid plaques was present in 78 patients (93%). Compared to the other patients, patients in the highest quartile of calcification volume (quartile 4) had higher serum creatinine levels (p < 0.001) and tended to have fewer symptomatic ischemic events in the territory of the affected carotid artery in the preceding 6 months (29 vs. 49%, p = 0.099); in particular, there were fewer transient symptoms (5 vs. 27%, p = 0.032) and symptoms possibly occurring due to local embolism (14 vs. 37%, p = 0.045). On ultrasound, plaque ulceration was less prevalent in patients in quartile 4 than in the remaining patients (5 vs. 29%, p = 0.026), although the severity of carotid stenosis was similar among all the quartiles.
Renal dysfunction was associated with enhanced carotid plaque calcification. Patients with severe carotid calcification were found to have a low risk of recent ischemic stroke, presumably due, in part, to a lower prevalence of emboligenic carotid ulceration. MDCT was valuable for the quantitative evaluation of carotid calcification.
确定使用多排螺旋计算机断层扫描（MDCT）定量测量的影响颈动脉斑块钙化程度的潜在因素，并研究颈动脉钙化与临床症状之间的关联。
我们对84例计划接受颈动脉血运重建术的连续患者，使用MDCT测量颈动脉分叉处狭窄病变的钙化体积。将这些结果与患者的临床和影像学特征进行比较。
在MDCT上，78例患者（93%）存在颈动脉斑块钙化。与其他患者相比，钙化体积处于最高四分位数（四分位数4）的患者血清肌酐水平更高（p<0.001），并且在之前6个月中，患侧颈动脉供血区域出现症状性缺血事件的倾向较少（29%对49%，p=0.099）；特别是短暂症状较少（5%对27%，p=0.032），以及可能因局部栓塞而出现的症状较少（14%对37%，p=0.045）。在超声检查中，四分位数4的患者斑块溃疡发生率低于其余患者（5%对29%，p=0.026），尽管所有四分位数的颈动脉狭窄严重程度相似。
肾功能不全与颈动脉斑块钙化增强有关。发现严重颈动脉钙化的患者近期发生缺血性卒中的风险较低，推测部分原因是致栓性颈动脉溃疡的发生率较低。MDCT对颈动脉钙化的定量评估具有重要价值。
