VascuCAP软件在脑卒中患者颈动脉粥样硬化斑块分析中的应用

Application of VascuCAP Software in the Analysis of Carotid Atherosclerotic Plaques in Stroke Patients

摘要: 目的：利用CT血管分析软件VascuCAP，分析缺血性脑卒中患者头颈CTA图像双侧颈动脉斑块的特征。方法：选取符合纳入标准的初发单侧脑卒中患者，126例。收集患者一般资料、对颈动脉CTA图像进行软件半自动定量分析，并根据头颅MRI检查结果，将脑卒中同侧颈动脉血管定义为有症状组，对侧颈动脉血管为无症状组。记录颈动脉狭窄程度、血管壁厚、斑块内出血(IPH)、钙化斑块(CALC)、富含脂质的坏死核心(LRNC)等参数，比较双侧颈动脉斑块成分差异。结果：单侧初发性脑卒中患者两组颈动脉粥样硬化斑块成分存在差异，有症状侧颈动脉组IPH体积(Z = 5.303, P < 0.001)和百分比(Z = 4.994, P < 0.001)明显大于无症状侧颈动脉组；有症状侧颈动脉最大狭窄程度高于无症状侧颈动脉(Z = 2.565, P = 0.01)；两组间其他斑块成分的体积、百分比无明显差异。有症状侧颈动脉最大狭窄程度与CALC、LRNC的体积和百分比、总斑块体积均呈正相关，无症状侧颈动脉最大狭窄程度与CALC体积、总斑块体积之间呈正相关。结论：脑卒中患者中有症状侧颈动脉斑块IPH体积、百分比以及最大狭窄程度均明显大于无症状侧颈动脉，分析结果与超声及MR颈动脉斑块相关先验研究结果一致。半自动血管分析软件VascuCAP在CTA颈动脉斑块成分分析中具有较高的应用价值。

Abstract: Objective: The purpose of this study was to analyze the characteristics of bilateral carotid plaques in head and neck CTA images of patients with ischemic stroke using CT vascular analysis software VascuCAP. Methods: A total of 126 patients with initial unilateral stroke who met the inclusion criteria were selected. The general information of the patients was collected, and the carotid CTA images were semi-automatically quantitatively analyzed by software. According to the results of cranial MRI examination, the ipsilateral carotid artery vessels of the stroke were defined as the symptomatic group, and the contralateral carotid artery vessels were defined as the asymptomatic group. The parameters such as the degree of carotid stenosis, vascular wall thickness, intraplaque hemorrhage (IPH), calcified plaque (CALC), and lipid-rich necrotic core (LRNC) were recorded to compare the differences in the composition of bilateral carotid plaques. Results: There were differences in the composition of carotid atherosclerotic plaques between the two groups of patients with unilateral primary stroke. The volume (Z = 5.303, P < 0.001) and percentage (Z = 4.994, P < 0.001) of IPH in the symptomatic carotid group were significantly greater than those in the asymptomatic group. The maximum stenosis of the symptomatic carotid was higher than that of the asymptomatic carotid (Z = 2.565, P = 0.01). There were no significant differences in the volume and percentage of other plaque components between the two groups. The maximum stenosis of the symptomatic carotid was positively correlated with the volume and percentage of CALC, LRNC, and total plaque volume. The maximum stenosis of the asymptomatic carotid was positively correlated with the volume of CALC and total plaque volume. Conclusion: The volume and percentage of IPH plaques, and maximum stenosis in the symptomatic carotid in stroke patients were significantly greater than those in the asymptomatic carotid. The analysis results were consistent with the results of prior studies on carotid plaques related to ultrasound and MR. The semi-automatic vascular analysis software VascuCAP has a high application value in the analysis of CTA carotid artery plaque components.