烟雾病患者岩骨段颈内动脉近端狭窄与弥漫性血管壁增厚相关:一项三维磁共振血管壁成像研究
Proximal internal carotid artery stenosis associates with diffuse wall thickening in petrous arterial segment of moyamoya disease patients: a three-dimensional magnetic resonance vessel wall imaging study.
作者信息
Chen Xiaoyi, Wang Jian, Liu Yang, Yang Yongbo, Zhou Fei, Li Xueping, Zhang Bing, Zhao Xihai
机构信息
Department of Radiology, Beijing Geriatric Hospital, Beijing, China.
Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
出版信息
Neuroradiology. 2019 Jan;61(1):29-36. doi: 10.1007/s00234-018-2124-z. Epub 2018 Nov 6.
PURPOSE
To investigate the association between proximal internal carotid artery (ICA) luminal narrowing and diffuse wall thickening (DWT) in ipsilateral petrous ICA in moyamoya disease (MMD) patients.
METHODS
Forty-one MMD (mean age 42.8 ± 11.0 years, 19 males) and 36 atherosclerotic patients (mean age 61.5 ± 7.1 years, 31 males) and 41 healthy controls were recruited and underwent carotid MR vessel wall imaging. The luminal narrowing of proximal ICA was evaluated by the diameter ratio of ICA to common carotid artery (DR). The wall thickness of petrous ICA was measured on T1-VISTA images. The enhancement degree of petrous ICA was recorded and graded into four grades (none to marked) on the CE-T1-VISTA images. The correlation between wall thickness in petrous ICA and DR was analyzed RESULTS: In total, 81 arteries of MMD patients and 64 arteries of atherosclerotic patients were included for analysis. The DR was significantly correlated with the wall thickness in petrous ICA in MMD (r = - 0.434, P < 0.001) and atherosclerotic groups (r = - 0.604, P < 0.001). Logistic regression analysis revealed that odds ratio (OR) of DR was 4.433 (95% CI 1.980-9.925, P < 0.001) and 2.212 (95% CI 1.253-3.905, P = 0.006) in MMD and atherosclerotic groups in discriminating petrous ICA DWT after adjusting for confounding factors. An increasing trend was found in prevalence of DWT and wall thickness with enhancement grades in petrous ICA in MMD (P = 0.02 and P = 0.01) and atherosclerotic groups (P < 0.001 and P < 0.001), respectively.
CONCLUSIONS
The proximal ICA luminal narrowing is significantly associated with wall thickness and diffuse wall thickening in ipsilateral petrous ICA in patients with carotid steno-occlusive diseases regardless of MMD or atherosclerosis.
目的
探讨烟雾病(MMD)患者颈内动脉(ICA)近端管腔狭窄与同侧岩骨段ICA管壁弥漫性增厚(DWT)之间的关系。
方法
招募41例MMD患者(平均年龄42.8±11.0岁,男性19例)、36例动脉粥样硬化患者(平均年龄61.5±7.1岁,男性31例)和41例健康对照者,均接受颈动脉磁共振血管壁成像检查。通过ICA与颈总动脉直径比(DR)评估ICA近端管腔狭窄情况。在T1-VISTA图像上测量岩骨段ICA的管壁厚度。在CE-T1-VISTA图像上记录岩骨段ICA的强化程度并分为四级(无强化至明显强化)。分析岩骨段ICA管壁厚度与DR之间的相关性。结果:共纳入81条MMD患者的动脉和64条动脉粥样硬化患者的动脉进行分析。在MMD组(r=-0.434,P<0.001)和动脉粥样硬化组(r=-0.604,P<0.001)中,DR与岩骨段ICA管壁厚度均显著相关。Logistic回归分析显示,在校正混杂因素后,MMD组和动脉粥样硬化组中DR鉴别岩骨段ICA DWT的比值比(OR)分别为4.433(95%CI 1.980-9.925,P<0.001)和2.212(95%CI 1.253-3.905,P=0.006)。MMD组(P=0.02和P=0.01)和动脉粥样硬化组(P<0.001和P<0.001)中,岩骨段ICA的DWT患病率和管壁厚度均随强化分级呈上升趋势。
结论
无论MMD还是动脉粥样硬化,颈动脉狭窄闭塞性疾病患者的ICA近端管腔狭窄均与同侧岩骨段ICA的管壁厚度及管壁弥漫性增厚显著相关。