摘要
目的分析缺血性卒中患者高分辨磁共振血管壁成像(HR-VWI)特点及价值。方法选取2020年10月至2021年12月聊城市第三人民医院收治的60例缺血性卒中患者为研究对象进行前瞻性研究,其中男34例,女26例,年龄25~75(53.27±6.22)岁。根据患者症状、病史、实验室检查及常规影像学检查进行初步中国缺血性卒中亚型(CISS)分型,且经HR-VWI检查后再次行CISS分型,对比HR-VWI检查前后CISS分型,分析血管壁成像特点,并根据患者斑块与缺血区责任动脉的关系分为责任斑块组(20例)与非责任斑块组(16例)。计量资料采用t检验,计数资料行χ^(2)检验,分析两组的HR-VWI特征。结果初步CISS分型为:大动脉粥样硬化型(LAA)20例(33.33%),心源性卒中型(CS)6例(10.00%),穿支动脉病变型(PAD)17例(28.33%),其他病因型(OE)1例(1.67%),病因不确定型(UE)16例(26.67%)。60例患者HR-VWI检查后60.00%(36/60)分型一致,40.00%(24/60)分型不一致。HR-VWI检查后大动脉粥样硬化型所占的比例升高了35.00%,穿支动脉病变型所占的比例下降23.33%,不明原因型所占的比例降低了13.33%,HR-VWI检查前后CISS分型率比较,差异有统计学意义(χ^(2)=17.833,P<0.05)。60例患者经HR-VWI检查颅内血管,30.00%(18例,25支)患者颅内血管壁未见明显异常,10.00%(6例,11支)患者发现管壁增厚,60.00%(36例,96支)患者颅内血管上发现粥样硬化斑块存在。责任斑块组管腔狭窄≥50%、斑块位置位于大脑中动脉、斑块明显强化者比例为40.00%(8/20)、55.00%(11/20)、50.00%(10/20),均高于非责任斑块组[6.25%(1/16)、25.00%(4/16)、6.25%(1/16)],差异均有统计学意义(χ^(2)=5.400、8.730、8.048,均P<0.05);责任斑块组管壁面积为(14.33±2.87)mm^(2),高于非责任斑块组的(11.76±1.14)mm^(2);管腔面积为(2.96±0.40)mm^(2),低于非责任斑块组的(5.44±1.29)mm^(2);狭窄率为(70.44±3.96)%,高于非责任斑块组的(39.15±2.04)%,差异均有统计学意义(t=3.368、8.147、28.
Objective To analyze the characteristics and value of high-resolution magnetic resonance imaging(HR-VWI)in patients with ischemic stroke.Methods A prospective study was conducted on 60 ischemic stroke patients admitted to Liaocheng Third People's Hospital from October 2020 to December 2021,including 34 males and 26 females who were 25-75(53.27±6.22)years old.The Chinese ischemic stroke subclassification(CISS)was used to classify the patients according to their symptoms,medical history,laboratory tests,and routine imaging examinations.CISS classification was performed again after HR-VWI examination.The CISS classification before and after HR-VWI examination was compared;the imaging characteristics were analyzed.According to the relationship between plaque and responsible artery in their ischemic areas,the patients were divided into a responsible plaque group(20 cases)and a non-responsible plaque group(16 cases).The measurement data and the count data were processed by t and χ^(2) tests,respectively.The HR-VWI characteristics of the two groups were analyzed.Results The CISS classification results showed that there were 20 cases(33.33%)of large arterial atherosclerosis(LAA),6 cases(10.00%)of cardioembolic stroke(CS),17 cases(28.33%)of perforating artery lesions,1 case(1.67%)of other etiological type(OE),and 16 cases(26.67%)of undetermined etiology(UE).Thirty-six(60.00%)of the 60 patients had the same type,and 24(40.00%)had different types before and after HR-VWI examination.After HR-VWI examination,the proportion of LAA type increased by 35.00%,the proportion of perforating artery lesion type decreased by 23.33%,and the proportion of UE type decreased by 13.33%.There was a statistical difference in CISS classification rate between before and after HR-VWI examination(χ^(2)=17.833,P<0.05).HR-VWI of intracranial blood vessels showed that of the 60 patients,30.00%(18 cases with 25 vessels)had no obvious abnormality on intracranial blood vessel walls;10.00%(6 cases with 11 vessels)had wall thickening;60.00%(36 cases w
作者
曲其志
张敏
赵艳玲
Qu Qizhi;Zhang Min;Zhao Yanling(CT Room,Liaocheng Third People's Hospital,Liaocheng 252000,China)
出处
《国际医药卫生导报》
2023年第4期559-564,共6页
International Medicine and Health Guidance News
关键词
缺血性卒中
高分辨磁共振
血管壁成像
诊断价值
Ischemic stroke
High-resolution magnetic resonance imaging
Vessel wall imaging
Diagnostic value
