3.0T高分辨核磁共振对颅内动脉粥样硬化的诊断价值研究
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摘要
目的探讨3.0T高分辨核磁共振对颅内动脉粥样硬化易损斑块的诊断价值研究。方法回顾性分析2018年1—10月经颅内超声或核磁共振血管成像证实颅内动脉症状性狭窄患者27例,应用3.0T高分辨MRI的对比增强技术对症状性颅内动脉粥样硬化患者进行动脉管壁成像,通过斑块的强化程度评估斑块的易损性,结合核磁功能成像,探讨易损斑块与缺血性脑血管病之间的关系。结果 27例症状性狭窄患者中,共51个动脉硬化斑块,其中40个斑块可见不同程度强化,11个斑块未见强化,即78%的责任斑块出现了症状性狭窄,两组间差异有统计学意义(χ2=14.436,P=0.000);两组狭窄程度比较结果显示,斑块强化组较非强化组狭窄程度更重,差异有统计学意义(χ2=10.745,P=0.001)。结论高分辨核磁共振有利于识别颅内症状性动脉硬化性狭窄,评估斑块的易损性,为临床的早期干预和治疗方案的选择提供重要依据。
Objective To investigate the diagnostic value of 3.0 T high-resolution nuclear magnetic resonance imaging in vulnerable plaque of intracranial atherosclerosis. Methods A retrospective analysis of 27 patients with symptomatic stenosis of the intracranial artery by intracranial ultrasound or magnetic resonance angiography from January to October 2018 was performed. The contrast enhancement technique of 3.0 T high-resolution MRI was used to treat symptomatic intracranial atherosclerosis. The sclerosing patients were imaged by arterial wall, the plaque vulnerability was evaluated by the degree of plaque enhancement, and the relationship between vulnerable plaque and ischemic cerebrovascular disease was explored in combination with nuclear magnetic functional imaging. Results Of the 27 patients with symptomatic stenosis, there were 51 arteriosclerotic plaques, 40 of which showed different degrees of enhancement, and 11 plaques showed no enhancement, i.e.,78% of the responsible plaques showed symptomatic stenosis, the difference between the two groups was statistically significant(χ2= 14.436, P=0.000). The comparison between the two groups showed that the plaque-enhanced group was more severe than the non-enhanced group. The difference was statistically significant(χ2=10.745, P=0.001). Conclusion High-resolution nuclear magnetic resonance is helpful for identifying intracranial symptomatic atherosclerotic stenosis and assessing the vulnerability of plaque, which provides an important basis for clinical early intervention and treatment options.
Objective To investigate the diagnostic value of 3.0 T high-resolution nuclear magnetic resonance imaging in vulnerable plaque of intracranial atherosclerosis. Methods A retrospective analysis of 27 patients with symptomatic stenosis of the intracranial artery by intracranial ultrasound or magnetic resonance angiography from January to October 2018 was performed. The contrast enhancement technique of 3.0 T high-resolution MRI was used to treat symptomatic intracranial atherosclerosis. The sclerosing patients were imaged by arterial wall, the plaque vulnerability was evaluated by the degree of plaque enhancement, and the relationship between vulnerable plaque and ischemic cerebrovascular disease was explored in combination with nuclear magnetic functional imaging. Results Of the 27 patients with symptomatic stenosis, there were 51 arteriosclerotic plaques, 40 of which showed different degrees of enhancement, and 11 plaques showed no enhancement, i.e.,78% of the responsible plaques showed symptomatic stenosis, the difference between the two groups was statistically significant(χ2= 14.436, P=0.000). The comparison between the two groups showed that the plaque-enhanced group was more severe than the non-enhanced group. The difference was statistically significant(χ2=10.745, P=0.001). Conclusion High-resolution nuclear magnetic resonance is helpful for identifying intracranial symptomatic atherosclerotic stenosis and assessing the vulnerability of plaque, which provides an important basis for clinical early intervention and treatment options.
引文
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[2]刘敬禹,宋涛,马超,等.3.0T高分辨率磁共振成像评估动脉粥样硬化性大脑中动脉狭窄[J].第二军医大学学报,2014,35(10):1141-1144.
[3]韩旭.症状侧与非症状侧颈动脉粥样硬化斑块特征的高分辨率磁共振成像研究[D].北京:中国人民解放军医学院,2014.
[4]雷云,丁里,任丽香,等.3.0T MRI对颈动脉粥样硬化斑块成分分析及分型的研究[J].磁共振成像,2015(6):430-436.
[5]沈雷,张永巍,吕楠,等.症状性大脑中动脉粥样硬化性狭窄的血流动力学数值模拟研究[J].中国卒中杂志,2016(1):54-60.
[6]Qiao Y,Zeiler SR,Mirbagheri S,et al.Intracranial Plaque Enhancement in Patients with Cerebrovascular Events on High-Spatial-Resolution MR Images[J].Radiology,2016,271(2):534-542.
[7]van Lammeren GW,den Ruijter HM,Vrijenhoek JEP,et al.Time-Dependent Changes in Atherosclerotic Plaque Composition in Patients Undergoing Carotid Surgery[J].Circulation,2016,129(22):2269-2276.
[8]Turan TN,LeMatty T,Martin R,et al.Characterization of intracranial atherosclerotic stenosis using high-resolution MRIstudy-rationale and design[J].Brain Behav,2015,5(12):397.
[9]Bang OY.Intracranial Atherosclerosis:Current Understanding and Perspectives[J].Journal of Stroke,2016,16(1):27.
[10]Lei C,Wu B,Liu M,Chen Y.Risk factors and clinical outcomes associated with intracranial and extracranial athero sclerotic stenosis acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2014,23(5):1112-1117.