摘要
目的探讨高分辨率磁共振成像(HRMRI)评估大脑中动脉(MCA)粥样硬化狭窄斑块特点。方法收集82例MCA粥样硬化M1段狭窄患者,根据磁共振弥散加权成像(DWI)同侧MCA供血区有无急性缺血性病灶分为症状性狭窄组(52例)和非症状性狭窄组(30例)。对MCAM1狭窄段进行HRMRI血管壁成像,记录并分析狭窄部位、斑块分布、信号强度、斑块负荷等特点。结果 MCA粥样硬化性狭窄多发生于M1近端(分叉前段),症状性狭窄组与非症状性狭窄组在M1段近端及远端(分叉后段)相比,差异无统计学意义(P>0.05);症状性狭窄组后壁、上壁及环形斑块所占比例明显高于非症状性狭窄组(8.33%vs.3.33%;16.67%vs.3.33%;18.75%vs.3.33%),非症状性狭窄组斑块多位于前壁、下壁(63.34%,26.67%),差异有统计学意义(P<0.05);症状性狭窄组混杂信号所占比例明显高于非症状性狭窄组,差异有统计学意义(P<0.05);斑块负荷检测症状性狭窄组最小管腔面积明显低于非症状性狭窄组[(0.66±0.25)mm^2 vs.(3.65±0.52)mm^2],差异有统计学意义(P<0.05),而管壁标准化指数、血管总面积、管壁面积明显高于非症状性狭窄组[(89.75±3.62)%vs.(36.78±7.88)%;(6.44±0.99)mm^2 vs.(5.83±0.87)mm^2;(5.78±0.92)mm^2 vs.(2.18±0.66)mm^2],差异有统计学意义(P<0.05)。结论 HRMRI血管壁成像能够清晰地显示MCA M1段血管壁结构,MCA粥样硬化狭窄多位于近端,后壁、上壁和环形斑块、斑块内混杂信号、负荷较大的斑块可能与急性缺血性脑卒中相关。
Objective To investigate the clinical value of high resolution magnetic resonance imaging(HRMRI)in the evaluation of the characteristics of the middle cerebral artery(MCA)atherosclerotic plaques.Methods Eighty-two patients with atherosclerotic stenosis were divided into the symptomatic(52 patients)and non-symptomatic group(30 patients)according to the diffusion-weighted MRI(DWI)which was applied to reveal whether acute ischemic lesions occur in the homolateral MCA territory.The vessel wall HRMRI was utilized to record the stenotic sites,plaque distribution,plaque signal intensity and plaque load of the MCA M1 stenotic segment.Results More atherosclerotic stenotic plaques were founded in MCA M1 proximal segment(forepart of the artery bifurcation).There was no significant difference in the plaque distribution in MCA M1 proximal or distal segment between symptomatic and non-symptomatic group(P>0.05).Significantly,more plaques were founded in the posterior,superior and annular vessel wall in symptomatic group than those in the non-symptomatic group(8.33%vs.3.33%;16.67%vs.3.33%;18.75%vs.3.33%,P<0.05).The plaques of the non-symptomatic group commonly located in the anterior and inferior vessel wall(63.34%and 26.67%);The proportion of the mixed signal in the scanning series was higher in the symptomatic group(P<0.05);Moreover,in the plaque load test,the minimum lumen area of symptomatic group was much smaller than that of the non-symptomatic group[(0.66±0.25)mm2 vs.(3.65±0.52)mm2,P<0.05].On the contrary,the normalized wall index,the total vessel area and the wall area of symptomatic group were distinctly higher than those of the non-symptomatic group[(89.75±3.62)%vs.(36.78±7.88)%;(6.44±0.99)mm2 vs.(5.83±0.87)mm2;(5.78±0.92)mm2 vs.(2.18±0.66)mm2,P<0.05,respectively].Conclusions HRMRI vessel wall imaging can clearly show the vessel structure of MCA M1 segment.The atherosclerotic stenotic plaques usually locate in MCA M1 proximal segment.The posterior,superior and annular vessel wall plaques,mixed signals in the pl
作者
王喜丰
李刚
张静
汪敏
肖瑶
沈伟
吕国义
金辉
王岚
WANG Xifeng;LI Gang;ZHANG Jing;WANG Min;XIAO Yao;SHEN Wei;Lü Guoyi;JIN Hui;WANG Lan(Department of Neurology,PUAI Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第14期2425-2429,共5页
The Journal of Practical Medicine
基金
湖北省科技厅计划项目(编号:2015CKC905)
关键词
高分辨率磁共振
大脑中动脉狭窄
斑块
high resolution magnetic resonance imaging
middle cerebral artery stenosis
plaque
