MRI检查对颈动脉粥样硬化斑块的诊断价值研究
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摘要
目的:研究MRI在脑梗死患者颈动脉粥样硬化斑块临床诊断评价中的应用。方法:选取MRI确诊为急性脑梗死颈动脉粥样硬化的患者纳入100例为观察组,并同期纳入80例在我院住院行CT颈部动脉血管造影的患者为对照组进行影像学对比,评价两种诊断方法对颈动脉粥样硬化斑块诊断的准确性。结果:观察组诊断颈动脉粥样硬化斑块个数与分布位置个数显著优于对照组,差异具有统计学意义(χ~2=28.079,31.660,18.217,21.701,P<0.05);两组患者经手术验证颈动脉粥样硬化斑块个数,差异无统计学意义(χ~2=17.089,19.286,P>0.05);图像质量分级比较显示观察组较对照组质量高,差异具有统计学意义(P<0.05)。与手术结果相比,对照组CT检测出的斑块平均直径有明显差异(P<0.05),而观察组MRI与术后结果无统计学差异(P>0.05)。结论:MRI诊断颈动脉粥样硬化斑块评价中,对斑块个数的诊出及对斑块分布位置的确定均有十分明显的临床优越性和准确性,且在影像资料的清晰度和成像质量方面更高。
Objective:To study the application of MRI in the diagnosis and evaluation of carotid atherosclerotic plaques in patients with cerebral infarction. Methods: 100 cases of carotid atherosclerosis in patients with acute cerebral infarction in 6 menstruation were included in the observation group, and 80 cases of cervical arteriography in our hospital were included in the same period as the contrast group, and the diagnosis of carotid atherosclerotic plaque was evaluated by two diagnosis methods. Results: The number and location of carotid atherosclerotic plaques in the observation group were significantly higher than those in the control group(χ~2 = 28.079, 31.660, 18.217, 21.701, P<0.05), and the number of carotid atherosclerotic plaques in the two groups was not statistically significant(χ~2 = 17.089, 19.286, P>0.05). The image quality grading comparison showed that the quality of the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05). Compared with the results of operation, the mean diameter of plaques detected by CT in the control group was significantly different(P< 0.05), but there was no significant difference between the MRI and postoperative results in the observation group(P>0.05).Conclusion: In the evaluation of carotid atherosclerotic plaque by MRI, the diagnosis of plaque number and the determination of the location of plaque have obvious clinical superiority and accuracy, and the clarity and imaging quality of the image data are higher than that of the arterial angiography. This diagnosis method is worthy of clinical application.
Objective:To study the application of MRI in the diagnosis and evaluation of carotid atherosclerotic plaques in patients with cerebral infarction. Methods: 100 cases of carotid atherosclerosis in patients with acute cerebral infarction in 6 menstruation were included in the observation group, and 80 cases of cervical arteriography in our hospital were included in the same period as the contrast group, and the diagnosis of carotid atherosclerotic plaque was evaluated by two diagnosis methods. Results: The number and location of carotid atherosclerotic plaques in the observation group were significantly higher than those in the control group(χ~2 = 28.079, 31.660, 18.217, 21.701, P<0.05), and the number of carotid atherosclerotic plaques in the two groups was not statistically significant(χ~2 = 17.089, 19.286, P>0.05). The image quality grading comparison showed that the quality of the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05). Compared with the results of operation, the mean diameter of plaques detected by CT in the control group was significantly different(P< 0.05), but there was no significant difference between the MRI and postoperative results in the observation group(P>0.05).Conclusion: In the evaluation of carotid atherosclerotic plaque by MRI, the diagnosis of plaque number and the determination of the location of plaque have obvious clinical superiority and accuracy, and the clarity and imaging quality of the image data are higher than that of the arterial angiography. This diagnosis method is worthy of clinical application.
引文
[1] 林慧怡.复发性与初发性脑梗死患者颈动脉粥样硬化斑块的比较[J].中国医师进修杂志,2014,8(14):11-12,40.
[2] 刘斌,石秋艳,李玉荣,等.脑梗死患者颈动脉粥样硬化斑块的调查及其相关因素分析[J].中国综合临床,2014,7(11):985-987.
[3] 王芳. 高频超声诊断老年糖尿病患者颈动脉粥样硬化斑块的价值分析[J]. 中国实验诊断学, 2017, 21(8):1302-1304.
[4] Nieuwstadt HA,Geraedts TR,Truijman MT,et al.Numerical simulations of carotid MRI quantify the accuracy in measuring atherosclerotic plaque components in vivo[J].Magn Reson Med,2014, 71(1): 188-201.
[5] 李阳.超声检测颈动脉粥样硬化对复发性脑梗死的预测价值[J].临床超声医学杂志,2013,19(27):28-29,54.
[6] Zheng YN, Liu GR, Wang BJ. Magnetic resonance imaging of carotid atherosclerotic plaque components[J]. Inl J Cerebrovasc Dis, 2013, 21(1): 51-53.
[7] 易兴阳,潘光强,余昌明,等.颈动脉粥样硬化与脑梗死复发的关系探讨[J].中华神经科杂志,2012,14(18):68-70.
[8] 唐旭, 王丽, 刘江. 颈动脉粥样硬化斑块超声在冠心病诊断中的意义[J]. 世界中医药, 2017,14(1):436-437.
[9] 张秀芳. 颈动脉粥样硬化斑块超声对冠心病临床诊断价值探讨[J]. 医学信息, 2016, 29(10):288-288.
[10] Pende A,Dallegri F.Is the Carotid Plaque Rupture a Pivotal Event in Stroke Pathogenesis? Update on the Role of the Intraplaque Inflammatory Processes[J].Curr Vasc Pharmacol,2013,13(2): 1570-1611.
[2] 刘斌,石秋艳,李玉荣,等.脑梗死患者颈动脉粥样硬化斑块的调查及其相关因素分析[J].中国综合临床,2014,7(11):985-987.
[3] 王芳. 高频超声诊断老年糖尿病患者颈动脉粥样硬化斑块的价值分析[J]. 中国实验诊断学, 2017, 21(8):1302-1304.
[4] Nieuwstadt HA,Geraedts TR,Truijman MT,et al.Numerical simulations of carotid MRI quantify the accuracy in measuring atherosclerotic plaque components in vivo[J].Magn Reson Med,2014, 71(1): 188-201.
[5] 李阳.超声检测颈动脉粥样硬化对复发性脑梗死的预测价值[J].临床超声医学杂志,2013,19(27):28-29,54.
[6] Zheng YN, Liu GR, Wang BJ. Magnetic resonance imaging of carotid atherosclerotic plaque components[J]. Inl J Cerebrovasc Dis, 2013, 21(1): 51-53.
[7] 易兴阳,潘光强,余昌明,等.颈动脉粥样硬化与脑梗死复发的关系探讨[J].中华神经科杂志,2012,14(18):68-70.
[8] 唐旭, 王丽, 刘江. 颈动脉粥样硬化斑块超声在冠心病诊断中的意义[J]. 世界中医药, 2017,14(1):436-437.
[9] 张秀芳. 颈动脉粥样硬化斑块超声对冠心病临床诊断价值探讨[J]. 医学信息, 2016, 29(10):288-288.
[10] Pende A,Dallegri F.Is the Carotid Plaque Rupture a Pivotal Event in Stroke Pathogenesis? Update on the Role of the Intraplaque Inflammatory Processes[J].Curr Vasc Pharmacol,2013,13(2): 1570-1611.