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目的探索评估颈部血管颅外段迂曲程度的新方法(弦弧比法),为进一步研究颈部血管迂曲的危险因素及其与脑血管病之间的关系提供参考依据。方法收集2011年1月至2015年7月于本院神经内科行全脑血管造影的163例患者的影像资料。采用血管造影机自带软件精确测量患者双侧颈内动脉起始部至颈内动脉C2段末端的实际长度;测量双侧椎动脉起始部至V2末端的实际长度。将起点与终点间的直线距离定义为理论长度,二者比值(弦弧比=实际长度/理论长度)定义为迂曲指数。以Metz法对造影图像进行再评估,按血管形态分为非迂曲、“C”形迂曲、折曲、盘曲,比较两组患者迂曲血管与非迂曲血管的迂曲指数。结果共测量592支血管的实际长度及理论长度,其中非迂曲血管302支(51.01%),“C”形迂曲血管205支(34.63%),折曲血管64支(10.81%),盘曲血管21支(3.55%)。非迂曲颈动脉迂曲指数为1.109±0.073,迂曲颈动脉迂曲指数为1.300±0.142,二者比较差异具有显著性(P<0.05)。非迂曲椎动脉迂曲指数为1.045±0.040,迂曲椎动脉迂曲指数为1.134±0.077,二者比较差异具有显著性(P<0.05)。结论采用弦弧比法评估血管迂曲程度理论上可行,优势在于其可定量分析评估血管迂曲程度,更加客观,易于操作,可重复性强。
Objective To explore a new method of evaluating the tortuosity of the extracranial segments of the cervical vessels (chord arc method), which provides a reference for further study on the risk factors of tortuous cervical vessels and their relationship with cerebrovascular disease. Methods The data of 163 patients with cerebral angiography in Department of Neurology from January 2011 to July 2015 were collected. The angiography software was used to measure the actual length of the C2 carotid artery from the beginning of bilateral internal carotid artery to the end of C2 carotid artery. The actual length of the bilateral vertebral artery to V2 distal end was measured. The straight-line distance between the start point and the end point is defined as the theoretical length, and the ratio of the two (chord arc ratio = actual length / theoretical length) is defined as the tortuosity index. Metz method to re-evaluate the contrast image, according to the vascular morphology is not tortuous, “C ” shape tortuosity, bending, tortuosity, tortuous tortuous blood vessels compared with the tortuous index of tortuous vessels in both groups. Results A total of 592 vessels were measured, including 302 non-tortuous vessels (51.01%), 205 C-shaped tortuous vessels (34.63%), 64 tortuous vessels (10.81%), Blood vessels in 21 (3.55%). The tortuosity index of non-tortuous carotid artery was 1.109 ± 0.073, and tortuosity index of tortuous carotid artery was 1.300 ± 0.142. There was significant difference between the two (P <0.05). The mean tortuous vertebral artery tortuosity index was 1.045 ± 0.040 and the tortuosity vertebral artery tortuosity index was 1.134 ± 0.077. There was significant difference between them (P <0.05). Conclusions It is theoretically feasible to evaluate the degree of blood vessel tortuosity by the chord-arc method. The advantage is that it can quantitatively evaluate the blood vessel tortuosity, which is objective, easy to operate and highly reproducible.