Arterial tortuosity in patients with spontaneous cervical artery dissection

作者：Giossi Alessia; Mardighian Dikran; Caria Filomena; Poli Loris; De Giuli Valeria; Costa Paolo; Morotti Andrea; Gamba Massimo; Gilberti Nicola; Ritelli Marco; Colombi Marina; Sessa Maria; Grassi Mario; Padovani Alessandro; Gasparotti Roberto; Pezzini Alessandro^*

来源：Neuroradiology, 2017, 59(6): 571-575.

DOI：10.1007/s00234-017-1836-9

• Arterial dissection
• Arterial tortuosity

The aim of this study was to test the hypothesis that patients with spontaneous cervical artery dissection (CeAD) have increased arterial tortuosity, and the objective quantification of such a tortuosity may aid in the identification of subjects at increased risk of disease.
In the setting of a hospital-based, case-control study, we used the vertebral tortuosity index (VTI) measured on magnetic resonance angiography, a validated method for the assessment and quantification of arterial tortuosity, to compare the degree of tortuosity in a series of consecutive patients with spontaneous CeAD and of age- and sex-matched patients with ischemic stroke unrelated to CeAD (non-CeAD IS) and stroke-free subjects.
The study group was composed of 102 patients with CeAD (mean age, 44.5 +/- 7.8 years; 66.7% men), 102 with non-CEAD IS, and 102 stroke-free subjects. The VTI was higher in the group of patients with CeAD (median, 7.3; 25th-75th percentile, 10.2) compared with that of non-CeAD IS (median, 3.4; 25th-75th percentile, 4.4) and of stroke-free subjects (median, 4.0; 25th-75th percentile, 2.9; p 0.001), and was independently associated to the risk of CeAD (OR, 1.18; 95% CI, 1.09-1.29) in multivariable regression analysis. The degree of tortuosity also tended to be higher in CeAD patients who experienced short-term recurrence (5.8%; median, 20.2; 25th-75th percentile, 31.2) than in those without recurrent events (median, 7.2; 25th-75th percentile, 9.4; p = 0.074).
CeAD patients exhibit increased arterial tortuosity. This might have potential implications for better understanding of the pathophysiology of the disease as well as clinical utility in evaluation, prognostication, and decision-making of affected individuals.

• 出版日期2017-6