41例颈动脉蹼患者的影像学及临床特征

doi:10.3969/j.issn.1673-5765.2020.03.006

摘要/Abstract

摘要：

目的探讨颈动脉蹼的影像学特点及其相关临床表现，提高对该病的认识及诊断能力。方法回顾性分析2016年1月-2018年12月于青岛大学附属医院行头颈部CTA检查的患者影像学资料，对其中符合颈动脉蹼诊断标准的患者的影像及临床特点进行分析总结。结果行头颈部CTA检查的8653例患者中，检出颈动脉蹼患者有41例（0.47%）。41例中典型部位的颈动脉蹼共38例（92.68%），26例（63.41%）位于颈内动脉，12例（29.27%）位于颈总动脉近分叉处；发生于颈动脉之外部位者共3例（7.32%），其中2例（4.88%）位于锁骨下动脉，1例（2.44%）位于椎动脉。41例患者共发现47个蹼结构，其中蹼附着于管腔后壁者33个（70.21%），位于侧壁者10个（21.28%），位于前壁者4个（8.51%）。41例患者最终诊断脑梗死者20例（48.78%），短暂性脑缺血发作者14例（34.14%），脑出血者3例（7.32%），其他表现者4例（9.76%）。结论颈动脉蹼在CTA上有典型的影像学特点，除最好发于颈内动脉及颈总动脉外，亦可见于颈部其他动脉如椎动脉及锁骨下动脉。蹼结构管腔内附着部位多见于后壁及侧壁，少数发生于前壁。颈动脉蹼与卒中的发生关系密切。

文章导读： 本文总结归纳41例动脉蹼患者的临床、影像特点，并发现颈动脉璞最常位于颈总动脉及颈内动脉，少数位于颈部的其他血管。

关键词: 颈动脉蹼; 卒中; CT血管造影

Abstract:

Objective To investigate the imaging features and clinical manifestations of patients with carotid web. Methods The imaging and clinical data of patients with carotid web from the Affiliated Hospital of Qingdao University between January 2016 and December 2018 were retrospectively analyzed, to summarize the imaging and clinical features of carotid webs. Results A total of 8653 patients underwent head and neck CTA, carotid webs were detected in 41 patients (0.47%). Among 41 cases, there were 38 (92.68%) cases with carotid webs in typical position, including 26 (63.41%) ones in internal carotid artery and 12 (29.27%) ones near the bifurcation of common carotid artery; and 3 (7.32%) cases with artery webs outside carotid artery, including 2 (4.88%) ones in subclavian artery and 1 (2.44%) in vertebral artery. A total of 47 webs were detected in the 41 patients. 33 (70.21%) webs were attached to the posterior wall of the lumen, 10 (21.28%) webs to the lateral wall, and 4 (8.51%) webs to the anterior wall. Of all the 41 cases, 20 (48.78%) cases were diagnosed with cerebral infarction, 14 (34.14%) with transient ischemic attack, 3 (7.32%) with cerebral hemorrhage and 4 (9.76%) with other manifestations. Conclusions Carotid webs has typical imaging features on CTA. Carotid webs are most often found in internal carotid artery and common carotid artery, and a few in other cervical arteries such as vertebral artery and subclavian artery. The attachment sites of web structures are more common in the posterior wall and lateral wall of the lumen, and less in the anterior wall. Carotid web is closely related to stroke occurrence.

Key words: Carotid web; Stroke; CT angiography

王明慧，张竹青，赵晗，牛蕾，段崇锋，赵继平，刘松，李滢，任延德，刘学军. 41例颈动脉蹼患者的影像学及临床特征[J]. 中国卒中杂志, 2020, 15(03): 257-262.

WANG Ming-Hui, ZHANG Zhu-Qing, ZHAO Han,NIU Lei, DUAN Chong-Feng, ZHAO Ji-Ping, LIU Song, LI Ying, REN Yan-De, LIU Xue-Jun. Imaging and Clinical Features of 41 Patients with Carotid Webs[J]. Chinese Journal of Stroke, 2020, 15(03): 257-262.

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