Apfaltrer Paul, Wenz Holger, Böhme Johannes, Gawlitza Matthias, Groden Christoph, Alonso Angelika, Förster Alex
Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
Clin Neuroradiol. 2021 Sep;31(3):827-831. doi: 10.1007/s00062-020-00941-y. Epub 2020 Aug 31.
Occlusion or significant stenosis of the internal carotid artery (ICA) in the cervical segment is commonly associated with a poststenotic decrease in the downstream blood flow and perfusion. Fluid attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) are a phenomenon that represents slow arterial blood flow. In this study, we investigated the frequency and extent of FVH in the distal ICA in patients with proximal ICA stenosis.
We analyzed the magnetic resonance imaging (MRI) findings in 51 patients with a total of 60 cervical ICA stenoses with special focus on the frequency and extent of FVH in the area of the petrous segment of the ICA on FLAIR images and correlated these with Doppler/duplex sonography results.
In 46 (76.7%) patients with ICA stenosis, FVH could be detected in the petrous segment of the ICA: in 19 (41.3%) patients a thin hyperintense rim near the vessel wall (grade 1), in 24 (52.2%) patients a strong hyperintense rim near the vessel wall (grade 2), and in 3 (6.5%) patients a hyperintense filling of the entire lumen (grade 3) was observed. The extent of FVH in the ICA in the petrous segment showed a high negative correlation with the poststenotic flow velocity (Spearman correlation, R = -0.75, p < 0.001), and moderate correlation with the degree of ICA stenosis (Spearman correlation, R = 0.51, p< 0.001).
An FVH in the petrous ICA is commonly seen among patients with steno-occlusive disease in proximal ICA and could therefore be useful to recognize a proximal ICA stenosis even on FLAIR images.
颈段颈内动脉（ICA）闭塞或严重狭窄通常与下游血流和灌注的狭窄后降低有关。液体衰减反转恢复（FLAIR）血管高信号（FVH）是一种代表动脉血流缓慢的现象。在本研究中，我们调查了近端ICA狭窄患者远端ICA中FVH的频率和范围。
我们分析了51例患者共60处颈段ICA狭窄的磁共振成像（MRI）结果，特别关注FLAIR图像上ICA岩骨段区域FVH的频率和范围，并将这些结果与多普勒/双功超声检查结果相关联。
在46例（76.7%）ICA狭窄患者中，可在ICA岩骨段检测到FVH：19例（41.3%）患者在血管壁附近有薄的高信号边缘（1级），24例（52.2%）患者在血管壁附近有强烈的高信号边缘（2级），3例（6.5%）患者观察到整个管腔的高信号填充（3级）。ICA岩骨段FVH的范围与狭窄后流速呈高度负相关（Spearman相关性，R = -0.75，p < 0.001），与ICA狭窄程度呈中度相关（Spearman相关性，R = 0.51，p < 0.001）。
岩骨段ICA中的FVH在近端ICA狭窄闭塞性疾病患者中常见，因此即使在FLAIR图像上也有助于识别近端ICA狭窄。
