[Study of correlation between carotid artery tortuosity and atherosclerotic carotid artery stenosis].

Objective: To investigate the correlation between carotid artery tortuosity and atherosclerotic carotid artery stenosis. Methods: A total of 73 patients who underwent carotid computed tomography angiography with unilateral atherosclerotic carotid artery stenosis at Department of Neurosurgery of Beijing Hospital from January 2011 to June 2016 were retrospectively reviewed. There were 51 males and 22 females ranging from 48 to 90 years old, the average age was (65.9±9.5) years. There were 38 patients with carotid stenosis in the left carotid artery and 35 in the right, the stenosis degree of carotid artery ranged from 30% to 90% with the median was 44.0% (25.5%). According to the degree of carotid artery stenosis, the patients were classified into mild stenosis group and moderate/severe stenosis group. There were 43 patients in the mild stenosis group with an average stenosis degree of (37.5±5.4)%, there were 30 patients in moderate/severe stenosis group with an average stenosis degree of (65.6±10.9)%. The carotid artery (CCA) tortuosity, extracranial internal carotid artery (EICA) tortuosity and CCA-ICA bifurcation tortuosity were quantified by measuring the CCA tortuosity index, EICA tortuosity index and the internal carotid artery (ICA) angle, respectively. Comparison of diseased and normal carotid arteries was performed using t test or Wilcoxon signed-ranked test. Results: There were no statistically significant differences in CCA tortuosity index (Z=-0.584, P=0.559), ICA angle (t=0.278, P=0.781), and EICA tortuosity index (Z=-0.377, P=0.706) between diseased and normal carotid arteries in 73 patients. The diseased carotid arteries showed larger ICA angles (39.0° (19.0°) vs. 30.0° (15.0°)) (Z=-2.439, P=0.015) in the mild stenosis group, but smaller ICA angles ((31.5±11.7)° vs. (39.1±16.2)°) (t=-2.529, P=0.017) in the moderate/severe stenosis group, compared with the contralateral normal carotid arteries. There was no statistically significant difference in CCA (Z=-0.720, P=0.472; Z=-0.013, P=0.990) and EICA tortuosity index (Z=-0.349, P=0.727; Z=-0.114, P=0.909) between diseased and normal carotid arteries. Conclusions: Compared with normal carotid arteries, carotid arteries with mild atherosclerotic stenosis demonstrate a more tortuous CCA-ICA bifurcation, while those with moderate/severe stenosis demonstrate a straighter CCA-ICA bifurcation. There is no correlation between CCA, EICA tortuosity and carotid artery stenosis.目的： 探讨颈动脉迂曲与颈动脉粥样硬化性狭窄的相关性。 方法： 回顾性分析北京医院神经外科自2011年1月至2016年6月行颈部计算机断层扫描血管造影的单侧颈动脉粥样硬化性狭窄的73例患者资料，男性51例，女性22例，年龄48～90岁，平均(65.9±9.5)岁；左侧颈动脉狭窄38例，右侧颈动脉狭窄35例；狭窄程度30%～90%，中位狭窄程度44.0%(25.5%)。按颈动脉狭窄程度分为轻度狭窄组43例，颈动脉平均狭窄程度(37.5±5.4)%；中重度狭窄组30例，颈动脉平均狭窄程度(65.6±10.9)%。测量患者的双侧颈总动脉(CCA)迂曲指数、颈内动脉(ICA)角和颅外段颈内动脉(EICA)迂曲指数，采用配对t检验或Wilcoxon符号秩和检验比较狭窄侧与正常侧颈动脉各项迂曲参数值的差异。 结果： 73例患者狭窄侧与正常侧颈动脉的CCA迂曲指数、ICA角及EICA迂曲指数差异均无统计学意义(Z＝－0.584，P＝0.559；t＝0.278，P＝0.781；Z＝－0.377，P＝0.706)。轻度狭窄组患者狭窄侧颈动脉的ICA角大于正常侧[39.0°(19.0°)比30.0°(15.0°)](Z＝－2.439，P＝0.015)；中重度狭窄组患者狭窄侧颈动脉的ICA角小于正常侧[(31.5±11.7)°比(39.1±16.2)°](t＝－2.529，P＝0.017)；两组狭窄侧与正常侧颈动脉的CCA(Z＝－0.720，P＝0.472；Z＝－0.013，P＝0.990)和EICA(Z＝－0.349，P＝0.727；Z＝－0.114，P＝0.909)的迂曲指数差异均无统计学意义。 结论： 同正常颈动脉相比，轻度动脉粥样硬化性狭窄颈动脉的CCA-ICA分叉部更迂曲，而中重度狭窄颈动脉的CCA-ICA分叉部更直；CCA和EICA的迂曲程度与颈动脉粥样硬化性狭窄无明显相关性。.