Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Vascular. 2024 Apr;32(2):424-432. doi: 10.1177/17085381221140163. Epub 2022 Nov 17.
To determine the association between the tortuosity of the internal carotid artery and vertebral artery and the occurrence of acute ischemic stroke based on a new quantitative method.
This retrospective case-control study was conducted on 63 patients diagnosed with acute ischemic stroke in the case group and 52 patients in the control group. All the participants underwent neck Computed Tomography Angiography. The images were retrospectively reviewed and the tortuosity index was measured for internal carotid and vertebral artery. Then, a multivariable binary logistic regression model adjusted for the potential confounders was performed to assess the independent effect of internal carotid/vertebral artery tortuosity on acute ischemic stroke.
Analysis of the logistic regression model revealed a significant effect of the internal carotid artery tortuosity index on anterior territory infarction (odds ratio = 1.04, = 0.01) as well as a significant effect of the vertebral artery tortuosity index on posterior territory infarction (odds ratio = 1.14, < 0.001). The optimal cut-off points for the internal carotid and vertebral artery tortuosity were 16.91 and 22.96, respectively.
This study showed that tortuosity of extracranial portions of the internal carotid and vertebral artery could be an independent imaging predictor of acute ischemic stroke in anterior and posterior circulation territories, respectively.
基于一种新的定量方法，确定颈内动脉和椎动脉迂曲与急性缺血性脑卒中发生之间的关系。
这是一项回顾性病例对照研究，纳入了 63 例急性缺血性脑卒中患者（病例组）和 52 例患者（对照组）。所有参与者均接受了颈部 CT 血管造影。对图像进行回顾性分析，并测量颈内和椎动脉迂曲指数。然后，通过多变量二元逻辑回归模型对潜在混杂因素进行调整，以评估颈内/椎动脉迂曲对急性缺血性脑卒中的独立影响。
逻辑回归模型分析显示，颈内动脉迂曲指数对前循环梗死具有显著影响（比值比=1.04， =0.01），而椎动脉迂曲指数对后循环梗死具有显著影响（比值比=1.14， <0.001）。颈内和椎动脉迂曲的最佳截断值分别为 16.91 和 22.96。
本研究表明，颈内和椎动脉颅外段迂曲可能分别是前循环和后循环急性缺血性脑卒中的独立影像学预测因素。
