CTA对不同部位急性颈内动脉闭塞特征的诊断效果评价

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Abstract Objective: To evaluate the diagnostic effect of characteristic CT angiography(CTA) patterns on the internal carotid artery(ICA) occlusion in different parts. Methods: The clinical characteristics and imaging characteristics of patients with acute ICA occlusion were analyzed retrospectively from January 2012 to December 2016 in our hospital. Diagnostic effect of characteristic CTA patterns on the ICA occlusion in different parts was evaluated using receiver operating characteristic(ROC) curve. The five diagnostic methods were: ①The carotid occlusion stump shape based on CTA; ②Carotid artery calcification based on CTA; ③The occlusion shape of Willis ring based on CTA; ④The leptomeningeal collaterals(LMC) based on CTA; ⑤The combined diagnosis of the above four diagnostic methods. Multivariate Logistic regression analysis of risk factors was also performed in patients with acute ICA occlusion with short-term poor prognosis. Results: A total of 161 patients were enrolled in this study, which were divided into three groups: 56 patients with C1 cervical segment occlusion, 72 patients with C4 cavernous segment occlusion, and 33 patients with C6 ophthalmic segment or C7 communicating segment occlusion. In the three groups of patients, the more distant the occlusion site was, the greater the degree of neurological deficit and the infarct volume were(P<0.05). The etiology of cerebral infarction, post-infarction complications and the prognosis of patients were related with the occlusion site(P<0.05). The imaging characteristics of CTA in patients with various parts of ICA occlusion were also different(P<0.05). ROC curve showed that the combined diagnosis of carotid artery occlusion stump shape, carotid artery calcification, the occlusion shape of Willis ring and LMC status was the best. The area under curve(AUC) for C1 cervical segment occlusion, C4 cavernous segment occlusion, C6 ophthalmic segment or C7 communicating segment occlusion were 0.966, 0.878, and 0.902, respectively. Older age and ICA distal occlusion were risk factors for poor prognosis. Conclusion: The clinical manifestations and CTA imaging findings of ICA occlusion are associated with occlusion location. The CTA-based combined diagnostic method can effectively differentiate the part of acute ICA occlusion, which is worthy to be widely promoted in the clinic.

Key words： Carotid artery, internal Arterial occlusive diseases Tomography, X-ray computed

Received: 21 August 2017

PACS:
	Ｒ543.4
	Ｒ814.42

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	Articles by authors
	MENG Shu-chun1
	HUANG Xian-hui1
	HAN Xing-jun1
	XIAO Jian-guo1
	ZHU Li-na2

Cite this article:

MENG Shu-chun1,HUANG Xian-hui1,HAN Xing-jun1, et al. Evaluation of diagnostic effect of CTA on the internal carotid artery occlusion of different parts[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(6): 413-418.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2018/V29/I6/413

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