摘要
目的 通过磁共振高分辨率血管壁成像(HR-VWI)技术,探究基底动脉血管形态以及动脉粥样硬化斑块特点在椎动脉优势(VAD)作用下的不同。方法 回顾性分析2019年9月至2022年9月哈尔滨医科大学附属第一医院磁共振科连续收治的基底动脉粥样硬化患者的临床及影像资料,根据VAD判定标准,将所有患者分为VAD组与非VAD组。收集患者的一般资料(性别、年龄、脑血管疾病危险因素等)和临床资料如实验室检查结果(同型半胱氨酸、血脂等)及影像学资料(MR检查资料),并根据HR-VWI图像分析基底动脉斑块特点,确定斑块的横向分布(包括腹侧壁、背侧壁、侧壁)以及纵向分布(远端、近端)。获得基底动脉最大管腔狭窄层面和参考层面的短轴横断面图像,测量感兴趣区(狭窄层和参考层)的管壁面积、管腔面积及血管面积,并根据公式计算狭窄程度、重构指数等,分析两组患者间临床资料及基底动脉形态学特征、斑块特征是否存在差异。结果 共纳入基底动脉粥样硬化患者71例,其中VAD组51例,非VAD组20例。与非VAD组比较,VAD组年龄更大[(62±12)岁比(56±16)岁,t=2.243,P=0.027],男性患者比例更高[74.5%(38例)比45.0%(9例),χ^(2)=5.591,P=0.018],低密度脂蛋白水平更高[(2.7±0.9) mmol/L比(2.3±0.8) mmol/L,t=2.356,P=0.028],差异均有统计学意义;两组基底动脉斑块的横向分布(χ^(2)=7.361,P=0.020)、纵向分布(χ^(2)=13.578,P=0.004)、狭窄程度[31.2(17.6,60.0)%比31.0(11.0,50.0)%,Z=7.552,P<0.01]差异均有统计学意义;VAD组狭窄处血管面积多于非VAD组[7.63(5.10,10.38) mm2比6.00(4.01,10.16) mm2,Z=6.018,P<0.01];VAD组基底动脉弯曲度较高[2.20(1.19,4.70) mm比0.35(0,1.86) mm;Z=3.428,P<0.01],且多向右侧弯曲[45.1%(23/51)比15.0%(3/20);χ^(2)=12.905,P=0.001]。结论 VAD对基底动脉斑块分布、狭窄程度及弯曲方向、弯曲程度等可能产生影响。
Objective Explored the influence of basilar artery(BA)vessel morphology and atherosclerotic plaque characteristics under the vertebral artery dominance(VAD)by using magnetic resonance high-resolution vessel wall imaging(HR-VWI).Methods The clinical and imaging data of consecutive patients with basilar atherosclerosis who attended the Department of Magnetic Resonance at the First Affiliated Hospital of Harbin Medical University from September 2019 to September 2022 were retrospectively analyzed.All the patients were divided into VAD and non-VAD groups according to the VAD determination criteria.General data(gender,age,risk factors for cerebrovascular disease,etc.)and clinical data such as laboratory findings(homocysteine,lipids,etc.)and imaging data(MR examination data)were collected from the patients,and the basilar artery plaque characteristics were analyzed based on the HR-VWI to determine the lateral distribution(including ventral,dorsal,and lateral walls)as well as the longitudinal distribution(distal and proximal)of the plaques.The short axis cross-sectional image of maximum lumen narrow and reference layer of basilar artery was obtained.The wall area,lumen area and vessel area of the interesting vessels(stenosis layer and reference layer)were also measured,and the degree of stenosis and remodeling pattern were calculated according to the formula to analyze whether there were differences in clinical data and morphological characteristics of the basilar artery and plaque characteristics between the two groups of patients.Results A total of 71 patients with BA atherosclerosis(51 cases in VAD group and 20 in non-VAD group)were included in this study.Compared with the non-VAD group,the age(62±12 vs.56±16,t=2.243,P=0.027),the proportion of male patients(74.5%[38 cases]vs.45.0%[9 cases],χ^(2)=5.591,P=0.018),and the low-density lipoprotein(LDL)levels([2.7±0.9]mmol/L vs.[2.3±0.8]mmol/L,t=2.356,P=0.028)was higher,all with statistically significant differences;there were statistically significant differences in t
作者
隋莹
孙佳莉
陈悦
邹文轩
周忠凯
徐畅
王巍
Sui Ying;Sun Jiali;Chen Yue;Zou Wenxuan;Zhou Zhongkai;Xu Chang;Wang Wei(Department of Magnetic Resonance,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2023年第4期239-247,共9页
Chinese Journal of Cerebrovascular Diseases
关键词
磁共振成像
基底动脉
斑块
动脉粥样硬化
磁共振高分辨率血管壁成像
基底动脉弯曲
椎动脉优势
Magnetic resonance imaging
Basilar artery
Plaque,atherosclerosis
High-resolution magnetic resonance vessel wall imaging
Basilar artery curvature
Vertebral artery dominance
