CTA与MRI评估无症状性颈动脉狭窄及其临床关联

目的:通过回顾性分析无症状性颈动脉狭窄患者的影像学表现，评估动脉粥样硬化疾病的发生发展及临床关联。方法:对81例行头颈部CT血管造影（CTA）的无症状性颈动脉狭窄患者进行回顾性分析，评估图像质量和动脉粥样硬化斑块的性质，并计算狭窄程度。对颈动脉狭窄程度与冠状动脉狭窄程度、颈动脉狭窄程度与脑白质病变程度、颈动脉狭窄程度与冠状动脉ACC/AHA评分作Pearson相关性检验。按照颈总-颈内动脉狭窄程度是否>50％可分为两组:A组和B组，对相应冠状动脉管腔狭窄程度分别作两组间独立样本t检验。并对头颅MRI检查结果进行评分，评分结果进行两组间t检验。按无症状性颈动脉狭窄组和对照组主动脉弓部粥样硬化的发生概率作χ2检验。结果:颈动脉狭窄程度与冠状动脉狭窄程度，颈动脉狭窄程度与脑白质病变程度，颈动脉狭窄程度与冠状动脉ACC/AHA评分均呈正相关；无症状性颈动脉狭窄患者与对照组相比，其相应冠状动脉斑块形成处狭窄程度，两组间t检验结果有显著统计学差异（P<0.05）。无症状颈动脉狭窄组相应头颅MRI表现为腔隙性脑梗死及脑白质病变者较对照组重，两组间t检验结果有显著统计学差异（P<0.05）。对颈总-颈内动脉狭窄程度主动脉弓部粥样硬化的发生概率作四格表χ2，检验有显著统计学差异（P<0.05）。结论:动脉粥样硬化是一种累及全身多部位大血管的疾病。颈动脉狭窄程度与相应冠状动脉粥样硬化病变以及主动脉粥样硬化病变的发展存在关联。冠状动脉狭窄程度与脑卒中及相应颈总-颈内动脉狭窄程度有关。 

CTA and MRI Evaluation of Asymptomatic Carotid Artery Stenosis and Its Clinical Association

objective: To retrospectively analyze the imaging findings of asymptomatic carotid artery stenosis patients to evaluate the occurrence and development of atherosclerotic disease and its clinical correlation. Methods: A retrospective analysis of 81 patients with asymptomatic carotid artery stenosis with head and neck CTA was conducted to evaluate the image quality and the properties of atherosclerotic plaques, and to calculate the stenosis degree. Pearson correlation test was performed for degree of carotid artery stenosis and coronary artery stenosis, degree of carotid artery stenosis and white matter lesions, degree of carotid artery stenosis and coronary artery ACC/AHA score. According to whether the degree of total internal carotid artery stenosis is >50% or not, it can be divided into two groups: asymptomatic carotid artery stenosis group and control group. Independent sample t test was conducted for the degree of coronary artery stenosis between the two groups. The results of head MRI were scored, and the t test between the two groups was performed. The incidence of atherosclerosis in aortic arch in asymptomatic carotid artery stenosis group and control group was evaluated by chi-sqaure test. Results: The degree of carotid artery stenosis was positively correlated with the degree of coronary artery stenosis, the degree of carotid artery stenosis with the degree of white matter lesion, and the degree of carotid artery stenosis with the degree of coronary artery ACC/AHA score compared with the control group, there were statistically significant differences in the t-test results of asymptomatic carotid artery stenosis in patients with coronary artery plaque formation (P<0.05). The corresponding head MRI findings in the asymptomatic carotid artery stenosis group showed lacunar cerebral infarction and white matter lesion were heavier than those in the control group, and there were significant statistical differences in t test results between the two groups (P<0.05).The incidence rate of atherosclerosis in the aortic arch was statistically significant by four-grid chi-square test (P<0.05). Conclusion: Atherosclerosis is a systemic disease. The degree of total internal carotid artery stenosis is associated with the development of coronary atherosclerosis and aortic atherosclerosis. The degree of coronary artery stenosis is related to the degree of stroke and the corresponding total internal carotid artery stenosis.