Department of Neurosurgery & Stroke Center, Rakuwakai Otowa Hospital, Kyoto, Japan; Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Hamamatsu Rosai Hospital, Shizuoka, Japan.
Department of Neurosurgery, Kishiwada Municipal Hospital, Osaka, Japan.
Eur J Radiol. 2014 Feb;83(2):384-90. doi: 10.1016/j.ejrad.2013.10.011. Epub 2013 Oct 27.
Simple rating scale for calcification in the cervical arteries and the aortic arch on multi-detector computed tomography angiography (MDCTA) was evaluated its reliability and validity. Additionally, we investigated where is the most representative location for evaluating the calcification risk of carotid bifurcation stenosis and atherosclerotic infarction in the overall cervical arteries covering from the aortic arch to the carotid bifurcation.
The aortic arch and cervical arteries among 518 patients (292 men, 226 women) were evaluated the extent of calcification using a 4-point grading scale for MDCTA. Reliability, validity and the concomitant risk with vascular stenosis and atherosclerotic infarction were assessed.
Calcification was most frequently observed in the aortic arch itself, the orifices from the aortic arch, and the carotid bifurcation. Compared with the bilateral carotid bifurcations, the aortic arch itself had a stronger inter-observer agreement for the calcification score (Fleiss' kappa coefficients; 0.77), but weaker associations with stenosis and atherosclerotic infarction. Calcification at the orifices of the aortic arch branches had a stronger inter-observer agreement (0.74) and enough associations with carotid bifurcation stenosis and intracranial stenosis. In addition, the extensive calcification at the orifices from the aortic arch was significantly associated with atherosclerotic infarction, similar to the calcification at the bilateral carotid bifurcations.
The orifices of the aortic arch branches were the novel representative location of the aortic arch and overall cervical arteries for evaluating the calcification extent. Thus, calcification at the aortic arch should be evaluated with focus on the orifices of 3 main branches.
评估一种用于多排螺旋 CT 血管造影（MDCTA）中颈动脉硬化和主动脉弓钙化的简单评分系统的可靠性和有效性。此外，我们还研究了评估从主动脉弓到颈总动脉分叉处整个颈动脉硬化性狭窄和粥样硬化性梗死的钙化风险的最具代表性的位置。
对 518 例患者（292 例男性，226 例女性）的主动脉弓和颈动脉硬化程度采用 4 分制评分标准进行评估。评估了可靠性、有效性以及与血管狭窄和粥样硬化性梗死的伴发风险。
钙化最常见于主动脉弓本身、主动脉弓分支的开口以及颈总动脉分叉处。与双侧颈总动脉分叉处相比，主动脉弓本身的钙化评分具有更强的观察者间一致性（Fleiss'kappa 系数为 0.77），但与狭窄和粥样硬化性梗死的相关性较弱。主动脉弓分支开口处的钙化具有更强的观察者间一致性（0.74），与颈总动脉分叉处狭窄和颅内狭窄有足够的相关性。此外，主动脉弓分支开口处广泛的钙化与粥样硬化性梗死显著相关，与双侧颈总动脉分叉处的钙化相似。
主动脉弓分支的开口是评估主动脉弓和整个颈动脉硬化钙化程度的新的有代表性的位置。因此，主动脉弓的钙化应重点评估 3 个主要分支的开口处。
