摘要
目的通过血管超声评估颈动脉蹼(CW)的结构特征。方法连续纳入2018年1月至2019年6月于首都医科大学宣武医院就诊的经超声检查并经CT血管造影(CTA)证实的CW患者共66例。根据超声对狭窄程度的判定,将患者分为颈动脉<50%狭窄组54例,≥50%狭窄组12例。应用超声测量CW的长度、厚度、与管壁间锐性夹角,记录CW上端的血流方向特征(顺向或逆向血流)、CW与管壁间血栓形成情况,比较2组间CW结构特征的差异,并分析不同颈动脉狭窄程度对缺血性脑卒中发生的影响。结果首次诊断为CW的患者为42例(42/66,63.6%),余24例患者首次检查分别诊断为溃疡斑块21例(21/66,31.8%)和夹层3例(3/66,4.5%)。<50%狭窄组与≥50%狭窄组CW的长度、厚度、方向、周边血栓情况差异均无统计学意义(P均> 0.05)。<50%狭窄组CW与管壁间夹角显著小于≥50%狭窄组(中位数:39°vs 73°,P=0.002),而<50%狭窄组中夹角≤60o的发生率也显著高于≥50%狭窄组(74.1%vs 41.7%,P=0.042)。<50%狭窄组CW处的颈动脉残余内径明显大于≥50%狭窄组,而收缩期峰值流速明显低于≥50%狭窄组,2组比较,差异均有统计学意义(P均<0.001)。缺血性脑卒中患者与非卒中患者的颈动脉狭窄程度差异无统计学意义(P=0.321)。结论超声通过二维及彩色多普勒模式可评估CW的结构特征,CW与管壁间夹角较大时更易导致局部血管狭窄≥50%,但血管狭窄并非导致CW患者脑卒中的重要原因。
Objective To evaluate the features of carotid web(CW) by ultrasonography. Methods A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a < 50% stenosis group(54 cases) or a ≥ 50% stenosis group(12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction(forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke. Results Forty-two(42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21(21/66, 31.8%) were diagnosed with ulcerative plaque and 3(3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups(P > 0.05). The angle between the web and carotid wall in the < 50% stenosis group was significantly smaller than that of the ≥ 50% stenosis group(median angel 39° vs 73°, P=0.002), and the percentage of patients with an angle ≤ 60° in the < 50% stenosis group was significantly higher than that of the ≥ 50% stenosis group(74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the < 50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the < 50% stenosis group than in the ≥ 50% stenosis group(P < 0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke(P=0.321). Conclusion Ultrasonography can be used to evaluate the characteristics of carotid web in 2 D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more l
作者
杨洁
华扬
周福波
田晓洁
刘然
贾凌云
Yang Jie;Hua Yang;Zhou Fubo;Tian Xiaojie;Liu Ran;Jia Lingyun(Department of Vascular Ultrasonography,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2020年第7期679-683,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
颈动脉蹼
颈动脉狭窄
超声检查
脑卒中
Carotid web
Carotid artery stenosis
Ultrasonography
Stroke
