Giossi Alessia, Mardighian Dikran, Caria Filomena, Poli Loris, De Giuli Valeria, Costa Paolo, Morotti Andrea, Gamba Massimo, Gilberti Nicola, Ritelli Marco, Colombi Marina, Sessa Maria, Grassi Mario, Padovani Alessandro, Gasparotti Roberto, Pezzini Alessandro
U.O Neurologia, Istituti Ospedalieri di Cremona, Cremona, Italy.
Sezione di Neuroradiologia, Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italy.
Neuroradiology. 2017 Jun;59(6):571-575. doi: 10.1007/s00234-017-1836-9. Epub 2017 May 11.
The aim of this study was to test the hypothesis that patients with spontaneous cervical artery dissection (CeAD) have increased arterial tortuosity, and the objective quantification of such a tortuosity may aid in the identification of subjects at increased risk of disease.
In the setting of a hospital-based, case-control study, we used the vertebral tortuosity index (VTI) measured on magnetic resonance angiography, a validated method for the assessment and quantification of arterial tortuosity, to compare the degree of tortuosity in a series of consecutive patients with spontaneous CeAD and of age- and sex-matched patients with ischemic stroke unrelated to CeAD (non-CeAD IS) and stroke-free subjects.
The study group was composed of 102 patients with CeAD (mean age, 44.5 ± 7.8 years; 66.7% men), 102 with non-CEAD IS, and 102 stroke-free subjects. The VTI was higher in the group of patients with CeAD (median, 7.3; 25th-75th percentile, 10.2) compared with that of non-CeAD IS (median, 3.4; 25th-75th percentile, 4.4) and of stroke-free subjects (median, 4.0; 25th-75th percentile, 2.9; p ≤ 0.001), and was independently associated to the risk of CeAD (OR, 1.18; 95% CI, 1.09-1.29) in multivariable regression analysis. The degree of tortuosity also tended to be higher in CeAD patients who experienced short-term recurrence (5.8%; median, 20.2; 25th-75th percentile, 31.2) than in those without recurrent events (median, 7.2; 25th-75th percentile, 9.4; p = 0.074).
CeAD patients exhibit increased arterial tortuosity. This might have potential implications for better understanding of the pathophysiology of the disease as well as clinical utility in evaluation, prognostication, and decision-making of affected individuals.
本研究旨在验证以下假设，即自发性颈内动脉夹层（CeAD）患者的动脉迂曲度增加，对这种迂曲度进行客观量化可能有助于识别疾病风险增加的个体。
在一项基于医院的病例对照研究中，我们使用磁共振血管造影测量的椎动脉迂曲指数（VTI）（一种用于评估和量化动脉迂曲度的有效方法），比较一系列连续性自发性CeAD患者与年龄和性别匹配的非CeAD相关性缺血性卒中（非CeAD IS）患者及无卒中患者的迂曲度程度。
研究组由102例CeAD患者（平均年龄44.5±7.8岁；66.7%为男性）、102例非CeAD IS患者和102例无卒中患者组成。与非CeAD IS患者（中位数3.4；第25-75百分位数4.4）和无卒中患者（中位数4.0；第25-75百分位数2.9）相比，CeAD患者组的VTI更高（中位数7.3；第25-75百分位数10.2）（p≤0.001），并且在多变量回归分析中与CeAD风险独立相关（OR 1.18；95%CI 1.09-1.29）。经历短期复发的CeAD患者（5.8%；中位数20.2；第25-75百分位数31.2）的迂曲度程度也往往高于无复发事件的患者（中位数7.2；第25-75百分位数9.4；p = 0.074）。
CeAD患者表现出动脉迂曲度增加。这可能对更好地理解该疾病的病理生理学以及在受影响个体的评估、预后和决策中的临床应用具有潜在意义。
