背景:颈动脉网(CaWs)是颈内动脉(ICA)中的纤维肌肉突起,导致轻度管腔狭窄(<50%),但可能在三分之一的看似隐源性中风中引起。了解CaW引起的血流动力学改变对于评估卒中风险至关重要。时间平均壁剪切应力(TAWSS)和振荡剪切指数(OSI)是与血管功能障碍和血栓形成有关的血液动力学参数。
目的:检验以下假设:“与轻度动脉粥样硬化或健康的颈动脉分叉相比,CaW与较低的TAWSS和较高的OSI相关。\"
方法:前瞻性研究。
方法:总共35名受试者(N=14个带有CaW的分叉,11F,年龄:49±10,10轻度动脉粥样硬化6F,年龄:72±9,11健康9F,年龄:42±13)。
■4D流量/STAR-MATCH/3DTOF/3TMRI,CTA.
结果:以两种方式分析了4D流速数据:1)使用ICA球段中的3DROI(预计会出现复杂的流型)来量化具有低TAWSS和高OSI的区域。2)垂直于颈动脉分叉的中心线放置2D平面,以详细分析TAWSS和OSI。
方法:独立样本Kruskal-Wallis-H检验,0.05用于统计学意义。
结果:在CaW受试者中,ICA灯泡中存在低TAWSS的表面积百分比为12.3±8.0%(95%CI:7.6-16.9),动脉粥样硬化1.6±1.9%(95%CI:0.2-2.9),健康受试者为8.5±7.7%(95%CI:3.6-13.4),所有差异均具有统计学意义(2=0.3[95%CI:0.05-0.5],P值CaWvs.健康=0.2)。OSI在组间的CCA中具有相似的值(2=0.07[95%CI:0.0-0.2],P值=0.5),但与动脉粥样硬化和正常受试者相比,CaW受试者分叉下游的OSI明显更高。OSI在分叉远端的1.5直径组之间返回相似的值(2=0.03[95%CI:0.0-0.2],P值=0.7)。
结论:与动脉粥样硬化患者或健康受试者相比,CaW患者的ICA球中存在较低的TAWSS和较高的OSI。
方法:2技术效果:阶段2。
BACKGROUND: Carotid webs (CaWs) are fibromuscular projections in the internal carotid artery (ICA) that cause mild luminal narrowing (<50%), but may be causative in up to one-third of seemingly cryptogenic strokes. Understanding hemodynamic alterations caused by CaWs is imperative to assessing stroke risk. Time-Average Wall Shear Stress (TAWSS) and Oscillatory Shear Index (OSI) are hemodynamic parameters linked to vascular dysfunction and thrombosis.
OBJECTIVE: To test the hypothesis: \"CaWs are associated with lower TAWSS and higher OSI than mild atherosclerosis or healthy carotid bifurcation.\"
METHODS: Prospective study.
METHODS: A total of 35 subjects (N = 14 bifurcations with CaW, 11F, age: 49 ± 10, 10 mild atherosclerosis 6F, age: 72 ± 9, 11 healthy 9F, age: 42 ± 13).
UNASSIGNED: 4D flow/STAR-MATCH/3D TOF/3T MRI, CTA.
RESULTS: 4D Flow velocity data were analyzed in two ways: 1) 3D ROI in the ICA bulbar segment (complex flow patterns are expected) was used to quantify the regions with low TAWSS and high OSI. 2) 2D planes were placed perpendicular to the centerline of the carotid bifurcation for detailed analysis of TAWSS and OSI.
METHODS: Independent-samples Kruskal-Wallis-H test with 0.05 used for statistical significance.
RESULTS: The percent surface area where low TAWSS was present in the ICA bulb was 12.3 ± 8.0% (95% CI: 7.6-16.9) in CaW subjects, 1.6 ± 1.9% (95% CI: 0.2-2.9) in atherosclerosis, and 8.5 ± 7.7% (95% CI: 3.6-13.4) in healthy subjects, all differences were statistically significant (ƞ2 = 0.3 [95% CI: 0.05-0.5], P-value CaW vs. healthy = 0.2). OSI had similar values in the CCA between groups (ƞ2 = 0.07 [95% CI: 0.0-0.2], P-value = 0.5), but OSI was significantly higher downstream of the bifurcation in CaW subjects compared to atherosclerosis and normal subjects. OSI returned to similar values between groups 1.5 diameters distal to the bifurcation (ƞ2 = 0.03 [95% CI: 0.0-0.2], P-value = 0.7).
CONCLUSIONS: Lower TAWSS and higher OSI are present in the ICA bulb in patients with CaW when compared to patients with atherosclerotic or healthy subjects.
METHODS: 2 TECHNICAL EFFICACY: Stage 2.