Können cervicale Lymphknoten vorhersagen, ob eine Carotisplaque vulnerabel ist?
Can cervical lymph nodes predict if a carotid plaque is vulnerable?
von Joelle Landsberger
Datum der mündl. Prüfung:2014-02-12
Betreuer:Prof. Dr. Michael Knauth
Gutachter:Prof. Dr. Michael Knauth
Gutachter:Prof. Dr. George Trendelenburg
Gutachter:Prof. Dr. Patricia Virsik-Köpp
EnglischIntroduction: In histological studies, patients with symptomatic carotid stenosis show characteristics of plaque vulnerability: a thin fibrous cap and a large lipid core. Inflammation is thought to contribute to rupture of the atherosclerotic plaque and generation of thrombemboli. Inflammatory processes also govern the appearance and number of lymph nodes. The purpose of this study was to determine wether any association exists between nodal size and number of cervical lmph nodes and a concomitant symptomatic carotid stenosis. Methods and Materials: Head and neck CT-angiography images of 66 patients were retrospectively analysed using multiplanar reconstructions. For lymph node size, the maximum short axis diameter was measured. The number of nodes was reported regarding location and relation to the carotid bifurcation. Statistical subgroup analysis were performed for patients with and without carotid stenosis and for symtpomatic versus asymptomatic clinical history. Results: In comparison of patients with (65%) and without (35%) carotid stenosis and of patients with symptomatic (72%) versus asymptomatic (28%) stenosis, no statistically significant difference in number and size of cervical lymph nodes was found, neither ipsilateral close to bifurcation nor contralateral. Also plaque surface (ulcerated vs. smooth) did not influence lymph node appearance. Conclusion: The role of inflammation within the appearance of a vulnerable carotid plaque is still unclear and in our study not reflected by number or size of cervical lymph nodes. Although the study is limited by the small number of patients, we conclude that lymph nodes are unsuitable as a predictive factor for the risk of instability and vulnerability of carotid plaque surface.
Keywords: Plaquemorphology; Carotis; Inflammation; Lymph nodes
Schlagwörter: Plaquemorphologie; Carotis; Entzündung; Lymphknoten