Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Acta Neurol Belg. 2021 Oct;121(5):1225-1233. doi: 10.1007/s13760-020-01353-y. Epub 2020 Apr 11.
This study investigated the imaging and clinical features of cervical artery web to improve disease diagnosis. Imaging and clinical data of 41 patients with cervical artery web were retrospectively analyzed and summarized in the context of the literature. Of the 8653 patients who underwent carotid computed tomography angiography (CTA) in the past 3 years at our hospital, 41 (0.47%) were diagnosed with cervical artery web. Among the 41 patients, there were 38 web structures in typical position, including 26 web structures located in the internal carotid artery and 12 in the proximal bifurcation of the common carotid artery. And the other three web structures were located outside carotid artery, including two in the subclavian artery and one in the vertebral artery. There were 47 web structures in 41 cases of cervical artery web; 35/41 (85.3%) were unilateral and 6/41 (14.7%) were bilateral. Among 41 patients, there were 20 patients who had cerebral infarction, 14 who experienced transient ischemic attack, 3 patients with cerebral hemorrhage; and 4 with other manifestations. Cervical artery web showed typical imaging features in the carotid CTA. Cervical artery web was most common in the internal carotid artery and at the bifurcation of the common carotid artery. It was also occasionally found in other rare artery such as vertebral and subclavian artery. Based on the various locations of web structure, we think it is necessary to rename carotid web as cervical artery web. Most of the attachment sites of the web structures were located in the posterior wall of the lumen, followed by the lateral wall; sites on the anterior wall were rare. Cervical artery web may be an underappreciated risk factor for stroke. And hypertension can increase the incidence of ischemic stroke in patients with cervical artery web.
本研究旨在探讨颈动脉血管壁结构（web）的影像学及临床特征，以提高对该病的诊断水平。本研究回顾性分析了 41 例经我院颈动脉计算机断层血管造影（CTA）检查确诊为颈动脉血管壁结构的患者的影像学及临床资料，并结合文献进行了总结。在过去 3 年中，我院共有 8653 例行颈动脉 CTA 检查的患者，其中 41 例（0.47%）被诊断为颈动脉血管壁结构。在这 41 例患者中，有 38 例血管壁结构位于典型部位，其中 26 例位于颈内动脉，12 例位于颈总动脉分叉处。另外 3 例血管壁结构位于颈动脉外，其中 2 例位于锁骨下动脉，1 例位于椎动脉。41 例患者共检出 47 处血管壁结构，其中单侧 35 例（85.3%），双侧 6 例（14.7%）。41 例患者中，20 例有脑梗死病史，14 例有短暂性脑缺血发作，3 例有脑出血，4 例有其他表现。颈动脉 CTA 可显示典型的血管壁结构影像学特征。颈内动脉和颈总动脉分叉处是血管壁结构最常见的发生部位，偶尔也可发生于椎动脉和锁骨下动脉等罕见部位。根据血管壁结构的不同附着部位，我们认为有必要将颈动脉血管壁结构更名为“颈动脉血管壁结构”。血管壁结构的附着部位多位于管腔后壁，其次为外侧壁，前壁少见。颈动脉血管壁结构可能是脑卒中的一个被低估的危险因素。高血压可增加颈动脉血管壁结构患者发生缺血性脑卒中的风险。
