Rafailidis Vasileios, Chryssogonidis Ioannis, Tegos Thomas, Partovi Sasan, Charitanti-Kouridou Afroditi, Staub Daniel
Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
1st Neurology Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Ultrasound. 2019 May;27(2):77-84. doi: 10.1177/1742271X18822658. Epub 2019 Jan 29.
The term "carotidynia" has been used to describe a symptom or a nosologic entity characterized by pain in the lateral neck region and over the carotid bifurcation. Recent advances in diagnostic imaging and the introduction of diagnostic criteria have led to the adoption of term "Transient perivascular inflammation of the carotid artery" (TIPIC) syndrome.
A retrospective analysis of the Radiology Department's database was performed to identify cases with the diagnosis of TIPIC syndrome. The purpose was to identify ultrasound images including B-mode technique, colour, power Doppler technique and contrast-enhanced ultrasound (CEUS).
In total, five patients with the diagnosis of TIPIC syndrome are presented in this review. TIPIC syndrome is a clinic-radiologic entity characterized by pain over the carotid area, a symptom referring to a wide differential diagnosis where imaging plays a crucial role for proper diagnosis and treatment. Characteristic imaging findings on conventional ultrasound and CEUS are presented in this review.
TIPIC syndrome can be investigated with virtually any imaging modality. Ultrasound typically reveals perivascular infiltration and a hypoechoic intimal plaque, while no significant luminal narrowing is appreciated. Computed tomography angiography and magnetic resonance angiography also demonstrate these vascular wall changes primarily affecting the distal common carotid artery, the carotid bulb and possibly the internal carotid artery proximal part. Contrast enhancement is a very characteristic and constant finding of TIPIC lesions, suggestive of the inflammatory nature of the disease and can be appreciated on computed tomography angiography and magnetic resonance angiography. CEUS has been recently used and successfully observed contrast enhancement of the lesions, similar to computed tomography angiography and magnetic resonance angiography.
Ultrasound remains the first-line modality for the evaluation of TIPIC syndrome, capable of providing all the information needed, especially if supplemented with the administration of microbubbles so that the enhancement of lesions can be evaluated.
“颈动脉痛”一词已被用于描述一种症状或疾病实体，其特征为颈部外侧区域及颈动脉分叉处疼痛。诊断成像技术的最新进展以及诊断标准的引入，促使人们采用了“颈动脉短暂性血管周围炎症”（TIPIC）综合征这一术语。
对放射科数据库进行回顾性分析，以确定诊断为TIPIC综合征的病例。目的是识别包括B超技术、彩色、能量多普勒技术及超声造影（CEUS）在内的超声图像。
本综述共呈现了5例诊断为TIPIC综合征的患者。TIPIC综合征是一种临床 - 放射学实体，其特征为颈动脉区域疼痛，该症状涉及广泛的鉴别诊断，而影像学检查对准确诊断和治疗起着关键作用。本综述展示了传统超声和CEUS上的特征性影像学表现。
几乎任何成像方式都可用于研究TIPIC综合征。超声通常显示血管周围浸润及低回声内膜斑块，而未发现明显的管腔狭窄。计算机断层血管造影（CTA）和磁共振血管造影（MRA）也显示这些血管壁变化主要影响颈总动脉远端、颈动脉球部以及可能的颈内动脉近端。对比增强是TIPIC病变非常典型且持续存在的表现，提示疾病的炎症性质，在CTA和MRA上均可观察到。CEUS最近已被应用，并成功观察到病变的对比增强，类似于CTA和MRA。
超声仍然是评估TIPIC综合征的一线检查方式，能够提供所需的所有信息，特别是在辅以微泡注射以便评估病变增强情况时。
