目的分析M R I高分辨技术(HRMRI)对复发性脑梗死患者颈动脉斑块特点的诊断价值。方法选取2015年4月至2018年4月我院收治的脑梗死患者262例为研究对象,其中复发性脑梗死者纳入研究组(n=162,检出斑块165个),初发性脑梗死者纳入对照组(n=1...目的分析M R I高分辨技术(HRMRI)对复发性脑梗死患者颈动脉斑块特点的诊断价值。方法选取2015年4月至2018年4月我院收治的脑梗死患者262例为研究对象,其中复发性脑梗死者纳入研究组(n=162,检出斑块165个),初发性脑梗死者纳入对照组(n=100,检出斑块105个),均于发病1周内行HRMRI检查,获得3D-TOF、高分辨率MRI黑血序列及CE-T1WI序列图像,对比两组所得图像,并以超微血流成像检查为准,分析HRMRI诊断颈动脉易损斑块的效能。结果研究组HRMRI下不稳定斑块检出率41.82%明显高于对照组28.57%(P<0.05);研究组管壁标准化指数(NWI)及斑块内出血(IPH)、斑块纤维帽破裂发生率高于对照组(P<0.05);以超微血流成像检查为准,HRMRI诊断复发性脑梗死患者颈动脉易损斑块的灵敏度、特异度、准确度、阳性预测值、阴性预测值、kappa一致性分别为95.35%、85.33%、88.52%、75.23%、97.52%、0.753。结论 HRMRI可较好评估复发性脑梗死患者颈动脉斑块性质及血管腔狭窄情况,检出易损斑块,值得在临床推广实践。展开更多
Purpose: The present study aimed to assess the associations of expansive remodeling of carotid arteries with ischemic symptoms and the degree of stenosis. Materials and Methods: A total of 41 symptomatic patients with...Purpose: The present study aimed to assess the associations of expansive remodeling of carotid arteries with ischemic symptoms and the degree of stenosis. Materials and Methods: A total of 41 symptomatic patients with vulnerable plaques and 25 asymptomatic individuals with stable plaques were included. All patients underwent 3.0T high-resolution MRI of the carotid artery(CA) for measuring the expansive remodeling(ER) ratio and assessing plaque stability. The ER ratio was calculated by dividing the maximum distance between the lumen and the outer border of the plaque in the internal CA by the lumen diameter within 1 centimeter of the plaque at the distal ipsilateral internal CA. ER ratios were compared between the symptomatic and asymptomatic groups. The 41 symptomatic patients were further divided into 4 groups according to stenosis rate(CA stenosis <50%, 50%–74%, 75–89%, and > 90%), and the correlation between the ER ratio and the rate of stenosis was evaluated. Results: There was a significant difference in ER ratio between the symptomatic and asymptomatic groups(p<0.001). When symptomatic patients were divided into 4 subgroups based on degree of stenosis, ER ratios among groups showed statistically significant differences(p=0.014). Conclusion: There were significant associations of the ER ratio with ischemic symptoms. Furthermore, the ER ratio in symptomatic patients continued to increase with stenosis severity. These findings suggested that the ER ratio might be a practical marker of plaque vulnerability in the CA and further prospective studies for asymptomatic patients are warranted.展开更多
文摘目的分析M R I高分辨技术(HRMRI)对复发性脑梗死患者颈动脉斑块特点的诊断价值。方法选取2015年4月至2018年4月我院收治的脑梗死患者262例为研究对象,其中复发性脑梗死者纳入研究组(n=162,检出斑块165个),初发性脑梗死者纳入对照组(n=100,检出斑块105个),均于发病1周内行HRMRI检查,获得3D-TOF、高分辨率MRI黑血序列及CE-T1WI序列图像,对比两组所得图像,并以超微血流成像检查为准,分析HRMRI诊断颈动脉易损斑块的效能。结果研究组HRMRI下不稳定斑块检出率41.82%明显高于对照组28.57%(P<0.05);研究组管壁标准化指数(NWI)及斑块内出血(IPH)、斑块纤维帽破裂发生率高于对照组(P<0.05);以超微血流成像检查为准,HRMRI诊断复发性脑梗死患者颈动脉易损斑块的灵敏度、特异度、准确度、阳性预测值、阴性预测值、kappa一致性分别为95.35%、85.33%、88.52%、75.23%、97.52%、0.753。结论 HRMRI可较好评估复发性脑梗死患者颈动脉斑块性质及血管腔狭窄情况,检出易损斑块,值得在临床推广实践。
基金Grants from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20152528)Shanghai Pujiang Program(16PJD036)+3 种基金Three-year plan program by Shanghai Shen Kang Hospital Development Center(16CR3043A)Shanghai Science and Technology Commission of Shanghai Municipality Program(14DZ1941206)the Cross Project of Medicine and Engineering from Shanghai Jiao Tong University(YG2015MS21)Shanghai key discipline of medical imaging(No.2017ZZ02005)
文摘Purpose: The present study aimed to assess the associations of expansive remodeling of carotid arteries with ischemic symptoms and the degree of stenosis. Materials and Methods: A total of 41 symptomatic patients with vulnerable plaques and 25 asymptomatic individuals with stable plaques were included. All patients underwent 3.0T high-resolution MRI of the carotid artery(CA) for measuring the expansive remodeling(ER) ratio and assessing plaque stability. The ER ratio was calculated by dividing the maximum distance between the lumen and the outer border of the plaque in the internal CA by the lumen diameter within 1 centimeter of the plaque at the distal ipsilateral internal CA. ER ratios were compared between the symptomatic and asymptomatic groups. The 41 symptomatic patients were further divided into 4 groups according to stenosis rate(CA stenosis <50%, 50%–74%, 75–89%, and > 90%), and the correlation between the ER ratio and the rate of stenosis was evaluated. Results: There was a significant difference in ER ratio between the symptomatic and asymptomatic groups(p<0.001). When symptomatic patients were divided into 4 subgroups based on degree of stenosis, ER ratios among groups showed statistically significant differences(p=0.014). Conclusion: There were significant associations of the ER ratio with ischemic symptoms. Furthermore, the ER ratio in symptomatic patients continued to increase with stenosis severity. These findings suggested that the ER ratio might be a practical marker of plaque vulnerability in the CA and further prospective studies for asymptomatic patients are warranted.
