Gutierrez Jose, Bagci Ahmet, Gardener Hannah, Rundek Tatjana, Ekind Mitchell S V, Alperin Noam, Sacco Ralph L, Wright Clinton B
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY.
J Neuroimaging. 2014 May-Jun;24(3):226-31. doi: 10.1111/j.1552-6569.2012.00781.x. Epub 2013 Jan 14.
Dolichoectasia (DE) is a vasculopathy that consists of abnormal elongation and dilatation of arteries. The objective of this study is to evaluate the frequency of DE in an unselected population and assess different diagnostic methods.
The Northern Manhattan Study is a multiethnic population based cohort of stroke-free participants. The definition proposed for DE was total cranial volume (TCV)-adjusted arterial diameter ≥2 SD. Other methods studied included visual assessment, unadjusted arterial diameters cutoff, Smoker's criteria and basilar artery (BA) volume.
A total of 718 subjects were included in the analysis (mean age 71.6 ± 8.0 years, 40% men, 61% Hispanic). Using the TCV-adjusted DE definition, 19% of the sample had at least one dolichoectatic artery. In 7% of the subjects, two or more arteries were affected. The BA was the most common dolichoectatic artery. Reproducibility for arterial diameter measurements was good to excellent (.70-.95), while for visual assessment ranged from fair to good (.49-.79).
A TCV-adjusted intracranial arterial diameter ≥2 SD is proposed as a useful DE definition. The variability in the prevalence of DE depending on the methods used underscores the need to agree on a reliable, universal definition of DE.
巨长扩张症（DE）是一种血管病变，由动脉异常伸长和扩张组成。本研究的目的是评估未选择人群中DE的发生率，并评估不同的诊断方法。
北曼哈顿研究是一项基于多民族人群的无卒中参与者队列研究。为DE提出的定义是经全颅容积（TCV）校正的动脉直径≥2个标准差。研究的其他方法包括视觉评估、未校正的动脉直径临界值、吸烟者标准和基底动脉（BA）容积。
共有718名受试者纳入分析（平均年龄71.6±8.0岁，40%为男性，61%为西班牙裔）。使用经TCV校正的DE定义，19%的样本至少有一条巨长扩张动脉。7%的受试者有两条或更多动脉受累。BA是最常见的巨长扩张动脉。动脉直径测量的可重复性良好至优秀（0.70 - 0.95），而视觉评估的可重复性从中等到良好（0.49 - 0.79）。
建议将经TCV校正的颅内动脉直径≥2个标准差作为有用的DE定义。DE患病率因所用方法而异，这突出了需要就可靠、通用的DE定义达成共识。
