Saba Luca, Sanfilippo Roberto, di Martino Michele, Porcu Michele, Montisci Roberto, Lucatelli Pierleone, Anzidei Michele, Francone Marco, Suri Jasjit S
Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy.
Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy.
J Stroke Cerebrovasc Dis. 2017 Mar;26(3):552-558. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.123. Epub 2017 Jan 11.
The purpose of this work was to explore the association between carotid plaque volume (total and the subcomponents) and cerebral microbleeds (CMBs).
Seventy-two consecutive (male 53; median age 64) patients were retrospectively analyzed. Carotid arteries were studied by using a 16-detector-row computed tomography scanner whereas brain was explored with a 1.5 Tesla system. CMBs were studied using a T2*-weighted gradient-recalled echo sequence. CMBs were classified as from absent (grade 1) to severe (grade 4). Component types of the carotid plaque were defined according to the following Hounsfield unit (HU) ranges: lipid less than 60 HU; fibrous tissue from 60 to 130 HU; calcification greater than 130 HU, and plaque volumes of each component were calculated. Each carotid artery was analyzed by 2 observers.
The prevalence of CMBs was 35.3%. A statistically significant difference was observed between symptomatic (40%) and asymptomatic (11%) patients (P value = .001; OR = 6.07). Linear regression analysis demonstrated an association between the number of CMBs and the symptoms (P = .0018). Receiver operating characteristics curve analysis found an association between the carotid plaque subcomponents and CMBs (A = .608, .621, and .615 for calcified, lipid, and mixed components, respectively), and Mann-Whitney test confirmed this association in particular for the lipid components (P value = .0267).
Results of this study confirm the association between CMBs and symptoms and that there is an increased number of CMBs in symptomatic patients. Moreover, we found that an increased volume of the fatty component is associated with the presence and number of CMBs.
本研究旨在探讨颈动脉斑块体积(总体积及各亚组分体积)与脑微出血(CMBs)之间的关联。
对72例连续患者(男性53例;中位年龄64岁)进行回顾性分析。使用16排螺旋CT扫描仪研究颈动脉,采用1.5T磁共振成像系统扫描脑部。采用T2*加权梯度回波序列检测CMBs。CMBs分为无(1级)至重度(4级)。根据以下Hounsfield单位(HU)范围定义颈动脉斑块的组分类型:脂质低于60 HU;纤维组织为60至130 HU;钙化高于130 HU,并计算各组分的斑块体积。由2名观察者对每条颈动脉进行分析。
CMBs的患病率为35.3%。有症状患者(40%)和无症状患者(11%)之间存在统计学显著差异(P值 = 0.001;OR = 6.07)。线性回归分析显示CMBs数量与症状之间存在关联(P = 0.0018)。受试者工作特征曲线分析发现颈动脉斑块亚组分与CMBs之间存在关联(钙化、脂质和混合组分的A值分别为0.608、0.621和0.615),曼-惠特尼检验尤其证实了脂质组分的这种关联(P值 = 0.0267)。
本研究结果证实了CMBs与症状之间的关联,且有症状患者的CMBs数量增加。此外,我们发现脂肪组分体积增加与CMBs的存在及数量相关。