Department of Radiology, 36657Kunming Medical University First Affiliated Hospital, Kunming, PR China.
Department of Neurosurgery, 36657Kunming Medical University First Affiliated Hospital, Kunming, PR China.
Acta Radiol. 2023 Jan;64(1):282-288. doi: 10.1177/02841851211065144. Epub 2021 Dec 13.
Internal carotid artery dissection (ICAD) is the major cause of ischemic stroke in young to middle-aged people. Recognition of predisposing factors may facilitate in early individual risk prediction and expand treatment.
To evaluate the association between a carotid web and dissection in patients with ICAD using vessel wall magnetic resonance imaging (VW-MRI).
A retrospective study was conducted of 223 patients who underwent VW-MRI. Of these patients, 58 patients with craniocervical artery dissection (CCAD) (33 ICAD and 25 vertebrobasilar artery dissection [VBAD]) were included. The control group (n = 165) consisted of patients without arterial dissection who had undergone VW-MRI . The presence of a carotid web in the posterior aspect of carotid bulb was recorded. The distance between the carotid web and start of dissection in ICA was recorded.
The presence of a carotid web showed a significant difference between the ICAD, VBAD, and control groups (19 [57.6%] vs. 5 [20%] vs. 36 [21.8%], respectively; < 0.001). In multi-nominal analysis, the presence of a carotid web showed a significant difference between the ICAD and VBAD groups and the ICAD and control groups ( < 0.05), with odds ratios of 5.41 (95% confidence interval [CI]=1.634-17.973) and 4.81 (95% CI=2.176-10.651), respectively. Out of 19 ICAD patients with carotid web, 16 had occurrence of dissection in the C1 segment of the ICA with a mean distance of 1.91 ± 1.71 cm from the carotid web.
Presence of a carotid web was more frequent in patients with ICAD. The carotid web may be one of the predisposing factors for development of dissection in patients with ICAD.
颈内动脉夹层（ICAD）是中青年缺血性脑卒中的主要原因。识别易患因素有助于早期进行个体风险预测，并扩大治疗范围。
使用血管壁磁共振成像（VW-MRI）评估颈动脉壁内中膜结节与 ICAD 患者夹层之间的关系。
对 223 例行 VW-MRI 的患者进行回顾性研究。其中，58 例颅颈动脉夹层（CCAD）患者（33 例 ICAD 和 25 例椎基底动脉夹层[VBAD]）纳入本研究。对照组（n=165）由行 VW-MRI 且无动脉夹层的患者组成。记录颈动脉球后壁内颈动脉壁内中膜结节的存在情况，并记录颈内动脉（ICA）起始处与夹层起始处之间的距离。
ICA 内的颈动脉壁内中膜结节在 ICAD、VBAD 和对照组之间存在显著差异（19 [57.6%]、5 [20%]和 36 [21.8%]，分别； < 0.001）。在多分类分析中，颈动脉壁内中膜结节在 ICAD 和 VBAD 组以及 ICAD 和对照组之间存在显著差异（ < 0.05），其比值比分别为 5.41（95%置信区间[CI]：1.634-17.973）和 4.81（95% CI：2.176-10.651）。19 例颈动脉壁内中膜结节的 ICAD 患者中，16 例发生在颈内动脉 C1 段的夹层，颈动脉壁内中膜结节与夹层起始处的平均距离为 1.91 ± 1.71cm。
颈动脉壁内中膜结节在 ICAD 患者中更为常见。颈动脉壁内中膜结节可能是 ICAD 患者发生夹层的一个潜在致病因素。
