磁共振测定颈动脉粥样硬化特征与急性脑梗死的关系  

Association of carotid atherosclerotic plaque characteristics determined by magnetic resonance imaging with acute ischemic stroke

作　　者：王嵇[1] 赵辉林[1] 曹烨[1] 刘晓晟[1] 赵子周[1] 赵锡海[2] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127 [2]清华大学生物医学影像研究中心

出　　处：《放射学实践》2012年第12期1320-1323,共4页Radiologic Practice

基　　金：上海市重点学科项目(S30203);上海交通大学医学院重点学科项目资助

摘　　要：目的:应用3.0T磁共振测定颈动脉斑块负荷、成分与急性脑梗死的发生及梗塞体积的相关性。方法:对62例急性颈内动脉供血区脑梗死患者行颈动脉血管壁磁共振检查,测量颈动脉管腔狭窄率和斑块负荷(最大管壁厚度及管壁体积标准化指数),评价斑块成分(坏死脂核,出血,钙化及纤维帽破裂),测得DWI急性脑梗死体积,计算OR值和Spearman秩相关系数。结果:症状侧颈动脉狭窄程度、最大管壁厚度、管壁体积标准化指数和斑块内出血、钙化和纤维帽破裂的发生率均高于非症状侧(P值均<0.05);症状侧颈动脉管壁体积标准化指数与同侧颈内动脉供血区急性脑梗死体积有较强的正相关(Spearman秩相关系数0.327,P<0.05)。斑块内出血和钙化是较强的急性脑梗死暴露因素(OR值分别为2.4和2.1,P值均<0.05)。结论:症状侧与非症状侧颈动脉斑块特征存在差异,且与急性脑梗死存在相关,提示这些特征可能为斑块不稳定重要因素。Objective：To evaluate the association of carotid atherosclerotic plaque characteristics determined by mag- netic resonance imaging with acute ischemic stroke. Methods： Sixty-two patients with acute isehemic stroke in the anterior circulation submitted to MR imaging of carotid vessel wall. The carotid plaque components and burden were evaluated and the volumes of acute isehemic stroke were measured on DWI. Odd ratio and Spearman＇s rank correlation coefficient were caeulated. Results：Compared with asymptomatic plaques, symptomatic plaques had larger plaque burden and higher incidence of fibrous cap rupture,hemorrhage and calcification （P〈0.05）. Positive correlation was found between percent wall volume with acute infarct volume. Intraplaque hemorrhage and calcification were positively associated with acute infarction （OR= 2.4 and 2. 1, P〈 0. 05）. Conclusion： This study reveals significant differences between symptomatic and asymptomatic plaques in the same patient. The associations of carotid plaque characteristics with acute ischemic stroke may suggest the vulnerability.

关 键 词：颈动脉 动脉粥样硬化 脑梗死 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]