摘要
【目的】探讨大脑中动脉(MCA)粥样硬化斑块影像学特征及其与急性脑梗死(ACI)发生的相关性。【方法】回顾性分析2020年1月至2022年10月本院收治的56例症状性MCA狭窄患者的临床资料,根据患者颅脑扩散加权成像(DWI)的结果将其分为ACI组和非ACI组(NACI组)。单因素分析两组患者管腔狭窄率、斑块位置、形态、长度及强化程度,采用多因素Logistic回归分析导致ACI的危险因素,采用受试者工作特征(ROC)曲线评估单个变量及其组合的预测效能。【结果】ACI组患者斑块长度及斑块强化所占比例高于NACI组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:斑块长度、斑块强化是症状性MCA狭窄患者发生ACI的独立危险因素(P<0.05)。管腔狭窄率、斑块长度、斑块强化及三者联合预测ACI发生的AUC分别是0.611、0.836、0.782、0.877,斑块长度和斑块强化程度对ACI的预测效能均高于管腔狭窄率(P<0.05),且三者联合可以显著提高对ACI的预测效能(P<0.05)。【结论】斑块长度和斑块强化是症状性MCA狭窄患者发生ACI的独立危险因素,两者在预测ACI的发生方面优于管腔狭窄,三者联合检测可以提高对ACI的预测效能。
【Objective】To investigate the relationship between the middle cerebral artery(MCA)atherosclerotic plaque and its correlation with acute cerebral infarction(ACI).【Methods】A total of 56 patients with symptomatic middle cerebral artery stenosis were collected and divided into acute cerebral infarction group(ACI group)and non-acute cerebral infarction(NACI group)according to diffusion weighted imaging(DWI).First,Univariate analysis was used to analyze the differences in the differences the lumen stenosis rate,plaque location,shape,length and enhancement degree between the two groups of patients.Binary logistic regression and receiver operating characteristic(ROC)curve were constructed to evaluate the efficacy of selected variables in predicting cerebral infarction.【Results】The plaque length and the proportion of plaque enhancement in the ACI group were higher than those in the NACI group,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that plaque length and plaque enhancement were independent risk factors for ACI in patients with symptomatic MCA stenosis(P<0.05).The AUC of lumen stenosis rate,plaque length,plaque enhancement and their combination to predict the occurrence of ACI were 0.611,0.836,0.782 and 0.877,respectively.The predictive efficacy of plaque length and plaque enhancement degree on cerebral infarction was higher than lumen stenosis rate(P<0.05),and the combination of the three could significantly improve the predictive efficacy of cerebral infarction(P<0.05).【Conclusion】The length and intensity of plaque are independent risk factors for ACI in patients with symptomatic MCA stenosis.Both of them are superior to lumen stenosis in predicting the occurrence of acute cerebral infarction.The combined detection of the three can improve the diagnostic efficacy of ACI.
作者
牛稳
邱晓晖
刘艺超
NIU Wen;QIU Xiao-hui;LIU Yi-chao(Medical Imaging Center,People's Hospital of Bozhou,Bozhou Anhui 236800)
出处
《医学临床研究》
CAS
2023年第2期161-164,共4页
Journal of Clinical Research
基金
中国红十字基金会项目基金(XM_HR-YXFN-2021-05-24)。
关键词
大脑中动脉
颅内动脉硬化/影像诊断
脑梗死
磁共振成像
Middle Cerebral Artery
Intracranial Arteriosclerosis/DG
Brain Infarction
Magnetic Resonance Imaging
