高分辨率MRI评估早期颈动脉粥样硬化患者双侧颈动脉分叉几何形态差异

High resolution MRI in evaluation on geometric morphologic differences of bilateral carotid bifurcation in patients with early carotid atherosclerosis

目的采用颈动脉高分辨MRI评估早期颈动脉粥样硬化患者左右侧颈动脉分叉几何形态的差异。方法对92例早期颈动脉粥样硬化患者采集颈动脉管壁高分辨MRI,观察双侧颈动脉管壁厚度及斑块分型,计算并比较左右侧颈动脉分叉几何参数的差异。结果左侧颈动脉管壁厚度[1.24(1.09,1.46) mm]与右侧[1.29(1.10,1.57) mm]差异无统计学意义(Z=-1.12,P=0.26);左右侧斑块分型差异无统计学意义(P=0.22)。左侧颈内动脉(ICA)平面角(Z=-2.69)、近端面积比(Z=-3.43)、颈总动脉(CCA)扩张面积比(Z=-2.87)、ICA_5~CCA_3弯曲度(Z=-3.17)及二维CCA弯曲度(Z=-2.14)均大于右侧(P均<0.05);左右侧颈动脉分叉角(Z=-1.23)、ICA角(Z=-8.89)差异无统计学意义(P均>0.05)。结论早期颈动脉粥样硬化患者左右侧颈动脉分叉几何结构存在显著差异,可能导致左右侧颈动脉斑块发生率不同。

Objective To investigate the differences of the left and right side carotid bifurcation geometry in patients with early carotid atherosclerosis using carotid high resolution MRI.Methods High resolution carotid vessel wall MRI of 92 patients with early carotid atherosclerosis were collected.The wall thickness and plaque types of left and right carotid arteries were analyzed,and geometric parameters of carotid bifurcation were calculated and compared between the left and the right side.Results There was no statistical difference of wall thickness between the left side[1.24(1.09,1.46)mm]and the right side[1.29(1.10,1.57)mm](Z=-1.12,P=0.26),nor of plaque types(P=0.22).The left side carotid bifurcation had larger internal carotid artery(ICA)plane angle(Z=-2.69),proximal area ratio(Z=-3.43),common carotid artery(CCA)area expansion ratio(Z=-2.87),ICA 5-CCA 3 tortuosity(Z=-3.17)and two dimensional CCA tortuosity(Z=-2.14)than the right side(all P<0.05).No significant difference of carotid bifurcation angle(Z=-1.23)nor ICA angle(Z=-8.89)was found between bilateral carotid arteries(both P>0.05).Conclusion The differences of carotid bifurcation geometry between the left and the right carotid arteries in patients with early carotid atherosclerosis might lead to different incidences of carotid arteries on the left and the right side.