家族性高胆固醇血症纯合子患者颈动脉病变的高分辨MRI成像  

Non-invasive detection of carotid artery atherosclerosis in homozygous familial hypercholesterolemia by high resolution MRI

作　　者：于薇[1] 王瑞[1] 蔺洁[2] 王绿娅[2] 张兆琪[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所动脉硬化研究室,100029

出　　处：《心肺血管病杂志》2009年第5期322-325,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:应用高分辨磁共振观察家族性高胆固醇血症纯合子患者颈动脉改变,明确动脉粥样硬化病变分布及类型,以便为FH患者临床治疗提供有价值的影像学依据。方法:采用高分辨磁共振对5例经临床诊断FH纯合子患者(男∶女=3∶2,平均年龄17岁,平均低密度脂蛋白胆固醇17.12 mmol/L)进行磁共振颈动脉血管壁及磁共振增强血管造影检查,观察动脉粥样硬化病变的分布,斑块类型,管腔狭窄程度,计算血管壁负荷。结果:所有患者颈总动脉、颈内动脉、颈外动脉均可见管壁增厚,斑块类型以早期的脂质斑块为主。在年龄较大的患者中斑块呈偏心性分布,管腔明显狭窄,并伴有较高的血管壁负荷。结论:高分辨MRI可以定性定量分析病变程度。为随访观察及个体化治疗提供有直观影像依据。Objective： To assess changes of carotid artery in homozygous familial hypercholesterolemia （HoFH） patients by high resolution magnetic resonance imaging; to identify the distribution and classification of arteriosclerotic lesion of HoFH patients and offer the valuable foundation for clinic treatment. Method： We studied five HoFH patients （three females, two males, mean age 17 years, age range 7-38 years, with a mean low density lipoprotein （LDL） cholesterol 17.12 mmol/L） using 3T MRI. Observe the distribution of atherosclerotic lesion, classification of lesion type, stenotic degree and calculate plaque burden by carotid wall image and contrast enhencement MR angiography. Result： All study subjects found the wall of artery become thicken in common carotid artery, internal carotid artery and external carotid artery All plaques demonstrated on the early stage with lipid rich/ necrotic core. The plaque shown eccentric distribution with lumen stenosis and high plaque burden on the elder patients. Conclusion：Our data suggest that high resolution MRI could be a useful non-invasive method to qualify and quantify the early carotid artery atherosclerosis in HoFH subjects. It is possible to provide significant foundation for individualized treatment of FH patients by regular non-invasive MRI.

关 键 词：高胆固醇血症 家族性 磁共振 颈动脉硬化 

分 类 号：R543.4[医药卫生—心血管疾病]