Department of Neurology, University Hospital of Muenster, Albert-Schweitzer-Strasse 33, 48149, Muenster, Germany.
J Neurol. 2011 Feb;258(2):250-4. doi: 10.1007/s00415-010-5737-7. Epub 2010 Sep 10.
The prevalence of elongation of the internal carotid arteries (ICA) is suggested to be significantly higher in patients with spontaneous cervical artery dissection (sCAD) than in other stroke patients. We reassessed this hypothesis in a case-control study by means of an improved semiautomated MR imaging technique. We compared the length of the cervical arteries in patients with and without sCAD. In 40 consecutive patients with MRI proven sCAD, we measured the arterial lengths of both ICA from the cervical bifurcation to the carotid-T, as well as both vertebral arteries (VA) from their origin to the vertebro-basilar junction. The measurements were performed on the basis of high-resolution, three-dimensional (3D) MR-angiographies with the use of specialized software calculating the length of the coaxial line of these arteries. These results were compared to the findings of 40 age-matched controls with an ischemic stroke due to other etiologies. The mean arterial lengths in patients with sCAD (left ICA 169.62 mm, right ICA 170.05 mm, left VA 233.56 mm, right VA 224.57 mm) compared to patients without sCAD (left ICA 171.07 mm, right ICA 171.88 mm, left VA 232.54 mm, right VA 222.08 mm) did not differ significantly. In our case-control study, cervical arteries are not elongated in patients with sCAD when compared to age-matched stroke patients due to other etiologies. The finding of an arterial elongation is not a distinct clinical marker in patients with suspected sCAD. The macroscopic appearance of the cervical arteries on MR-angiograms does not suggest an underlying elongative or dilatative arteriopathy.
颈内动脉（ICA）延长的发生率在自发性颈内动脉夹层（sCAD）患者中明显高于其他卒中患者。我们通过改进的半自动磁共振成像技术在病例对照研究中重新评估了这一假设。我们比较了 sCAD 患者和无 sCAD 患者的颈内动脉长度。在 40 例经 MRI 证实的 sCAD 患者中，我们测量了颈内动脉分叉至颈动脉-T 段的双侧 ICA 长度，以及起源至椎基底动脉连接部的双侧椎动脉（VA）长度。使用专门的软件在高分辨率三维（3D）MR 血管造影的基础上进行了这些测量，该软件可计算这些动脉同轴线的长度。将这些结果与因其他病因导致缺血性卒中的 40 名年龄匹配的对照组进行比较。sCAD 患者的平均动脉长度（左侧 ICA 169.62mm，右侧 ICA 170.05mm，左侧 VA 233.56mm，右侧 VA 224.57mm）与无 sCAD 患者（左侧 ICA 171.07mm，右侧 ICA 171.88mm，左侧 VA 232.54mm，右侧 VA 222.08mm）相比无显著差异。在我们的病例对照研究中，与因其他病因导致的年龄匹配的卒中患者相比，sCAD 患者的颈内动脉并未延长。在疑似 sCAD 患者中，动脉延长不是一个明显的临床标志物。MR 血管造影上颈内动脉的宏观表现不提示潜在的延长或扩张性血管病。
