Department of Neurosurgery, Chugoku Rousai Hospital, Tagaya 1-5-1, Hiro, Kure-shi, Hiroshima, 737-0193, Japan.
Neurosurg Rev. 2013 Jul;36(3):421-7. doi: 10.1007/s10143-012-0445-7. Epub 2012 Dec 14.
We evaluated associations between cerebral blood flow (CBF) and histopathological features in atherosclerotic lesions of the internal carotid artery. Cerebrovascular reactivity (CVR) and CBF were measured in 72 patients with unilateral carotid artery stenosis who underwent Xe-CT before carotid endarterectomy. Collateral blood flow was estimated as stump pressure. Proportions of fibrous tissue, intraplaque hemorrhage (IPH), and calcification were pathologically compared with the entire plaque body. The Spearman's rank test and stepwise multiple linear regression analysis revealed that the IPH rate significantly and negatively correlated with CBF, whereas the calcification rate positively correlated with CVR. One-way analysis of variance showed that IPH and the absence of calcification might confer a risk for CBF and CVR reduction. Thus, not only the stenosis rate but also the degree of IPH and calcification in carotid arterial plaque are notable risk factors for ischemic stroke.
我们评估了大脑血液流量（CBF）与颈内动脉粥样硬化病变组织病理学特征之间的关联。72 名单侧颈动脉狭窄患者在颈动脉内膜切除术前行 Xe-CT 检查，测量了脑血管反应性（CVR）和 CBF。残端压力估计了侧支血流。纤维组织、斑块内出血（IPH）和钙化的比例与整个斑块体进行了病理比较。Spearman 秩检验和逐步多元线性回归分析显示，IPH 率与 CBF 显著负相关，而钙化率与 CVR 呈正相关。单因素方差分析表明，IPH 和无钙化可能会增加 CBF 和 CVR 降低的风险。因此，颈动脉斑块中不仅狭窄率，而且 IPH 和钙化的程度也是缺血性脑卒中的显著危险因素。
