| PART 1 EFFECTS OF MORPHOLOGICAL CHANGES IN INTERNAL CAROTID ARTERY ON COGNITIONObjective : To investigate the effect of morphologicalchanges(tortuosity and stenosis)in internal carotid artery(ICA)on cognition.Methods:Selected 39 patients in our hospital from October 2017 to June 2018 and 20 controls.According to cranio-cervical CT angiography and cranio-cervical MR imaging,ICA tortuosity group 23 cases and ICA stenosis group 16 cases in 39 patients.MMSE and MOCA were used to evaluate the cognitive function each group.And white matter lesions were evaluated by the Fazekas score,numbers of lacune were calculated.Results:The MOCA score was 27(24,29)in ICA tortuosity group,28(25,29)in ICA stenosis group and 29(28,30)in control group.There were significant differences in ICA tortuosity group compared with controls,P<0.05.There were no significant differences in MMSE between3 groups.There were significant differences in ICA tortuosity group and ICA stenosis group compared with control on Fazekas score of white matter lesions,P<0.05.There were significant differences between ICA stenosis group(9)with control group(2)and ICA tortuosity(1)group inlacune,P<0.05.Compared to other 2 groups,events of smoking,drinking,hypertension,hyperlipidemia were obviously higher in ICA stenosis group,P<0.05.Inconclusion Morphological changes(tortuosity and stenosis)in ICA are related to white matter lesions and lead to a certain degree of cognitive decline.PART 2 IMAGING FEATURES AND FOLLOW-UP VALUES OF INTERNAL CAROTID ARTERY DISSECTIONObjective To improve the diagnostic rate and reduce misdiagnosis or under diagnosis for internal carotid artery dissection(ICAD)by analyzing Imaging features and reflecting the follow-up values of High resolution magnetic resonance imaging and CT angiography.Methods Retrospectively analyzed 48 patients with suspected ICAD [patients of28 ICAD and 20 Atherosclerosis(AS)were confirmed by clinic] on imagine features of HR-MRI and CT angiography.All 48 patients received CTA examination,7 patients of which received HR-MRI examination in one week.9 ICAD patients prognosis of followed up for 3 to15 months,7patients were followed up with CTA,1 case with intramural hematoma was followed up with HR-MRI for 4 times,1 case was followed up with HR-MRI at first time and CTA at second time.Results32 blood vessels with ICAD were detected in the total of 28 ICAD patients,In those 21 patients with ICAD detected with CTA and 7Intramural hematoma patients were detected with HR-MRI which missed by CTA.The common CTA characteristic features of ICAD were intimal flaps,double-lumen sign,and aneurysmatic expansion,a total of 19 cases with these features(68%,19/28),calcification 1 case and eccentrial stenosis9 cases.The imaging features of 7cases with Intramural hematoma detected with HR-MRI were high crescent sign in T1 WI and T2 WI.The CTA features of 20 AS patients were intimal flaps 7 cases,double-lumen sign 5cases,aneurysmatic expansion 6 cases,calcification 14 case and eccentrial stenosis 5 cases.5 of 7 patients were followed up with CTA with no change,2 cases with intramural hematoma were absorbed completely.1 case with intramural hematoma was followed up with HR-MRI for 4 times,the intramural hematoma of which were absorbed completely but remained vessel wall edema.1case was followed up with HR-MRI at first time,the intramural hematoma of which were absorbed mostly,and which was followed up with CTA at second time,the thickening vessel wall and narrow lumen remained.Conclusion The common CTA characteristic features of ICAD were intimal flaps,double-lumen sign,and aneurysmatic expansion without calcification almostly.HR-MRI which can display tube cavity and tube wall at the same time.For the cases which can't confirmed with CTA,it could be detected with HR-MRI to avoid missed diagnosis and misdiagnosis of ICAD.HR-MRI can clearly display the absorption of intramural hematoma and wall edema,so it is superior than CTA for the follow up of intramural hematoma. |
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