多排螺旋CTA测量不同分型颈动脉分叉角相关参数

Measurement of Different Types of Carotid Artery Bifurcation Angle by Multi-slice Spiral CT Angiography

目的:探讨应用多排螺旋CTA图像后处理技术测量颈动脉分叉角几何学指标的价值。方法:收集行多排螺旋CT头颈部血管成像没有明显异常的受检者350例,根据TF-AHCB模型颈动脉分叉角分为Ⅰ、Ⅱ及Ⅲ型组;利用医学图像后处理软件测量颈动脉分叉角(α)、颈总动脉远端内径(A)、颈内动脉膨大近端内径(B)、颈内动脉膨大处内径(C)、颈内动脉膨大远端内径(D)及颈外动脉内径(E)6项指标,观察受检者不同性别及左右侧颈总动脉这6项指标的变化。结果:Ⅰ型α(24.70±11.17)°、A(6.25±0.97)mm、B(6.12±1.42)mm、C(6.81±1.39)mm、D(4.03±0.81)mm、E(3.39±0.97)mm,Ⅱ型α(40.71±15.55)°、A(6.68±0.97)mm、B(6.70±1.41)mm、C(7.82±3.36)mm、D(4.25±0.82)mm、E(3.29±0.75)mm,Ⅲ型α(65.03±16.95)°、A(6.84±1.07)mm、B(7.27±1.78)mm、C(7.82±1.47)mm、D(4.28±0.81)mm、E(3.35±0.85)mm;Ⅰ、Ⅱ、Ⅲ型颈动脉分叉角除E值外均有明显差异(P<0.05),其中α值呈线性正相关;Ⅰ、Ⅱ、Ⅲ型左右侧颈动脉分叉角6项指标均无明显差异(P>0.05)。结论:多排螺旋CTA图像后处理技术提供颈动脉分叉角较为可靠的正常参考值。不同分型间颈动脉分叉角呈线性正相关。

Objective： To measure the geometry index of carotid artery bifurcation angle by multislice spiral CTA（ CT angiography） imaging. Methods： 350 cases of patients who had been screened by multi-slice spiral CTA on the head and neck without any obvious abnormality were collected. Then they were divided into typeⅠand typeⅡ and type Ⅲ groups according to TF-AHCB model. The post processing software of medical image was adopted to measure the geometry index of carotid artery bifurcation angle,including the carotid artery bifurcation angle（ α）,the distal inner diameter of the common carotid artery（ A）,the proximal inner diameter of the internal carotid artery enlargement area（ B）,the width of the internal carotid artery enlargement area（ C）,the distal inner diameter of the internal carotid artery enlargement area（ D）,and the inner diameter of the external carotid artery（ E）.These 6 indicators were observed and compared between different gender and between left side and right side carotid artery. Results： The geometry factors of type Ⅰ were as follows： α（ 24. 70 ±11. 17） °,A（ 6. 25 ± 0. 97） mm,B（ 6. 12 ± 1. 42） mm,C（ 6. 81 ± 1. 39） mm,D（ 4. 03 ± 0. 81）mm,E（ 3. 39 ± 0. 97） mm; The geometry factors of type Ⅱwere as follows： α（ 40. 71 ± 15. 55） °,A（ 6. 68 ± 0. 97） mm,B（ 6. 70 ± 1. 41） mm,C（ 7. 82 ± 3. 36） mm,D（ 4. 25 ± 0. 82） mm,E（ 3. 29± 0. 75） mm; The geometry factors of type Ⅲ were as follows： α（ 65. 03 ± 16. 95） °,A（ 6. 84 ±1. 07） mm,B（ 7. 27 ± 1. 78） mm,C（ 7. 82 ± 1. 47） mm,D（ 4. 28 ± 0. 81） mm,E（ 3. 35 ± 0. 85）mm. The carotid artery bifurcation angle between type I,II and III were significantly different（ P〈0. 05）,and adjusted R（ 0. 370） exhibited positive linear correlation. Compared with women,6 geometry indexes of carotid artery bifurcation angle in type I and type II and B,C,D,E in type III were significantly higher（ P〈0. 05）. There was no significant difference in α and A of the type III between different sex（ P〈0. 05）. There were no significant differences in 6 indexes of type I,II and III between different sides（ P〈0. 05）. Conclusion： Multi-slice spiral CTA imaging can provide relatively reliable normal reference value of carotid artery bifurcation angle,and different types of carotid artery bifurcation angle exhibit positive linear correlation.