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目的虹吸部钙化在头颅平扫CT(UCT)中常见,但其与邻近颈内动脉狭窄(CAS)的关系尚不清楚。本研究探讨虹吸部钙化与CAS的关系。方法本回顾性研究得到机构审查委员会的豁免,纳入连续160例疑诊卒中的病人[年龄(64±14)岁,女63例],均行头UCT及头颈部CTA检查。根据CTA将CAS分为无、轻度(<50%)、中度(50%～69%)和重度(≥70%)狭窄。比较颈内动脉虹吸部钙化及其形状(在UCT上)和体积(在CTA上)与CAS的相关性。结果 41%的病人未见颈内动脉虹吸部钙化,如有钙化,则94%为双侧。存在钙化、钙化的形状和体积与重度CAS的似然比分别为10.1、3.9和8.4,95%CI分别为1.3~79.6、1.1~14.1和2.6~26.8。相应的阴性预测值(NPV)分别为0.98、0.98和0.96,阳性预测值(PPV)分别为0.14、0.07和0.29。结论 UCT未见颈内动脉虹吸部钙化对可疑卒中病人的颈内动脉狭窄具有很高的阴性预测价值。虹吸部钙化不是颈内动脉重度狭窄的可靠预测因子。要点①很多卒中病人的颈内动脉虹吸部无钙化。②颈内动脉狭窄≥50%不太可能见于无虹吸部钙化的卒中病人。③颈内动脉虹吸部钙化不能有效预测颈内动脉重度狭窄。
Purpose Siphon calcifications are common in cranial CT (UCT), but their relationship with adjacent internal carotid artery stenosis (CAS) remains unclear. This study explored the relationship between siphon calcifications and CAS. METHODS: This retrospective study was exempted by the institutional review board and included 160 consecutive patients with suspected stroke [age (64 ± 14) years, 63 females] underwent head CT and UCT. CAS was categorized as None, mild (<50%), moderate (50% -69%), and severe (> 70%) stenosis according to CTA. Comparisons of carotid siphon calcification of the internal carotid artery with its shape (on the UCT) and volume (on the CTA) were compared with CAS. RESULTS: No carotid siphon was found in 41% of the patients, and 94% were bilateral if calcified. Likelihood ratios for the presence of calcified, calcified shapes and volumes to severe CAS were 10.1, 3.9 and 8.4, respectively, and the 95% CIs were 1.3 to 79.6, 1.1 to 14.1 and 2.6 to 26.8, respectively. The corresponding negative predictive value (NPV) was 0.98, 0.98 and 0.96 respectively, and the positive predictive value (PPV) was 0.14, 0.07 and 0.29, respectively. Conclusion No calcification of siphon in the internal carotid artery in UCT has a very high negative predictive value for carotid stenosis in patients with suspected stroke. Siphon calcification is not a reliable predictor of severe carotid artery stenosis. Points ① Many stroke patients have no calcification of the siphon of the internal carotid artery. ② carotid artery stenosis ≥ 50% is not likely to be found in non-siphoned calcified stroke patients. ③ carotid siphon calcification can not effectively predict severe carotid artery stenosis.