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学科主题: 放射医学
题名:
颈内动脉虹吸部狭窄的三维构型分析
其他题名: Analysis of 3D geometry in the stenosis of internal carotid artery siphon
作者: 谢晟1; 张驰1; 李德玉1; 李淑宇1; 肖江喜1; 黄一宁1
关键词: 颈动脉狭窄 ; 磁共振血管造影术 ; Carotid stenosis ; Magnetic resonance angiography
刊名: 中华放射学杂志
发表日期: 2010
DOI: 10.3760/cma.j.issn.1005-1201.2010.05.012
卷: 44, 期:5, 页:499-503
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 分析颈内动脉虹吸部狭窄患者与正常人在局部血管三维构型中的差别.方法 虹吸部狭窄组共29例,其中男20例,女9例,平均年龄58.6岁,吸烟者9例;对照组31例,男17例,女14例,平均年龄67.5岁,吸烟者5例.对2组病例的动脉狭窄易患因素进行统计学比较.对性别、吸烟情况进行x2检验,对动脉收缩压、血糖浓度、血脂浓度进行Student-t检验.所有狭窄组和对照组的MRA原始数据在计算机上以Mimics软件进行后处理,对虹吸部的2个弯曲在各自的平面上进行外接圆的拟合,计算拟合出来的曲率半径(ACR)的几何平均值.以配对t检验检验对照组双侧ACR之间是否存在差别.根据虹吸部狭窄的部位不同,将虹吸部狭窄组分为C2段狭窄组和C4段狭窄组.对C2段狭窄组、C4段狭窄组和对照组的ACR以多组秩和检验进行统计学比较.此外,以配对t检验对单侧C2段狭窄的患者进行狭窄侧和正常侧ACR的统计学比较.结果 虹吸部狭窄组和对照组在性别、吸烟数量的差异没有统计学意义(χ2=1.63,P>0.05;χ2=1.86,P>0.05).虹吸部狭窄组收缩压为(146.6±21. 3)mm Hg(1 mm Hg=0.133 kPa),对照组为(140.3±17.3)mm Hg;虹吸部狭窄组血糖浓度为(5.94±1. 89)mmol/L,对照组为(6.79±3.57)mmol/L;虹吸部狭窄组血清总胆固醇和甘油三酯水平分别为(4.57±0.87)和(1.34 ±0.63)mmol/L,对照组为(4.75±1.70)和(1.54±0.72)mmol/L,它们的差异均没有统计学意义(t值分别为1.24、1.16、0.71和1.16,P值均>0.05).对照组中左侧ACR为(3.82±0.69)mm,右侧ACR为(4.08±1.04)mm,配对t检验显示两者之间差异无统计学意义(t=-1.44,P>0.05).多组秩和检验显示对照组与C2、C4狭窄组3组之间的差异具有统计学意义(χ2=6.67,P<0.05).两两比较表明在对照组和C2段狭窄组之间差异有统计学意义(t=2.63,P<0.05),而C4段狭窄组与其他2组之间的差异无统计学意义.单侧C2段狭窄的患者中,正常侧的ACR为(3.96±1.04)mm,狭窄侧的ACR为(3.41 ±0.61)mm,配对t检验显示狭窄侧和正常侧之间有存在差异的统计学趋势(t=2.09,P=0.05).结论 颈内动脉虹吸部C2段狭窄患者的局部构型与正常人相比,具有更小的曲率半径,这意味着颈内动脉虹吸部的局部构型可能影响狭窄的发生. Objective To identify the differences of 3D geometry of internal carotid artery (ICA)siphon between the controls and patients with ICA siphon stenosis. Methods The clinical and imaging data of the inpatients underwent carotid artery MRA in the past three years were collected. All patients were divided into the control group ( 17 males and 14 females with mean age of 67. 5 years) and ICA siphon stenosis group (20 males and 9 females with mean age of 58.6 years). There were 5 smokers and 9 smokers in two groups, respectively. The atherosclerotic predisposing factors were compared between the two groups using chi-square test and paired t-test. In order to extract the 3D geometry of ICA siphon, the MRA data were transferred to PC and processed with the software of Mimics. The average curvature radius (ACR) was calculated and paired t-test was applied to determine the bilateral differences in the controls. According to the stenotic site of ICA siphon, ICA siphon stenosis group was divided into C2 segment stenosis group and C4 segment stenosis group. The differences of ACR among the control group, C2 segment stenosis group and C4 segment stenosis group were compared. In addition, the values of ACR in the stenotic and normal sides were compared with paired t-test in patients with unilateral C2 segment stenosis. Results No significant differences were found in gender and smoker between the control group and the ICA siphon stenosis group ( χ2 = 1.63, P > 0. 05; χ2 = 1.86, P > 0. 05 ). The systolic blood pressure was ( 146. 6 ± 21.3 ) mm Hg ( 1 mm Hg =0. 133 kPa) and ( 140. 3 ± 17. 3) mm Hg respectively in the ICA siphon stenosis group and the control group. The serum glucose level was ( 5.94 ± 1.89 ) mmol/L and ( 6. 79 ± 3.57 ) mmol/L respectively in two groups. The serum cholesterol level and triglyceride level were (4. 57 ± 0. 87 ) mmol/L,( 1.34 ± 0. 63 ) mmol/L and (4. 75 ± 1.70) mmol/L, ( 1.54 ± 0. 72) mmol/L respectively in two groups.There were no differences in the atherosclerotic predisposing factors between two groups (t = 1.24, 1.16,0. 71 and 1.16 respectively,P> 0. 05). In the control group, the ACRs on the left and right were (3. 82 ±0. 69) mm and (4. 08 ± 1.04) mm respectively and no difference was found ( t = - 1.44, P > 0. 05 ).Kruskal-Wallis test revealed that there were significant differences among the controls, C2 segment stenosis group and C4 segment stenosis group ( χ2 = 6. 67, P < 0. 05 ). The ACR was significantly different only between the controls and C2 segment stenosis group ( t = 2. 63, P < 0. 05 ). The stenotic side had a tendency to have less ACR than the normal side (t =2. 09, P =0. 05) in patients with unilateral C2 segment stenosis. Conclusion Patients with smaller ACR are more susceptible to have the stenosis of C2 segment in ICA siphon, and 3D geometry may be a possible reason for the development of the ICA stenosis.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/42282
Appears in Collections:北京大学第一临床医学院_放射治疗科_期刊论文

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作者单位: 1.北京大学第一医院放射科,100034
2.北京航空航天大学生物工程系
3.北京大学第一医院神经内科,100034
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