高分辨3D黑血磁共振定量评价颈动脉粥样硬化斑块  

Quantitative measurement of carotid atherosclerotic plaque by high-resolution three-dimensional black-blood magnetic resonance imaging

作　　者：刘丹青[1] 王庆军 蔡剑鸣[1] 蔡幼铨[1] 王勇[3] 韩旭[1] 

机构地区：[1]解放军总医院放射科,北京100853 [2]解放军海军总医院医学影像科,北京100037 [3]解放军252医院放射科,河北保定071000

出　　处：《南方医科大学学报》2013年第3期365-369,共5页Journal of Southern Medical University

基　　金：全军"十二五"科研计划面上项目(CWS11J065)

摘　　要：目的通过与高分辨2D黑血磁共振成像技术比较,评价3D黑血磁共振成像(3D-BB-MRI)对颈动脉粥样硬化斑块定量分析的价值。方法 40例患者进行颈动脉常规轴位2D-BB-MRI及斜矢状位3D-BB-MRI扫描。对斜矢状位3D-BB-MRI原始图像进行轴位重建。对于每个测量对象(单侧颈动脉),由两名有经验的放射科医师在2D-BB-MRI图像上共同找出其斑块测量的兴趣层面,以此进行3D-BB-MRI轴位重建图像与2D-BB-MRI图像的匹配。对该侧颈动脉分别进行斑块厚度、管腔狭窄程度、管腔面积、总血管面积的测量及管壁面积和标准化管壁指数的计算,并分析所有数据。结果在评估斑块厚度、管腔狭窄程度、管腔面积、总血管面积、管壁面积及标准化管壁指数方面,2D-BB-MRI与3D-BB-MRI轴位重建图像的测量差异无统计学意义(P>0.05),两者呈较强的相关性(r>0.9)。Bland-Altman图显示对于测量斑块厚度、管腔面积、总血管面积,2D-BB-MRI与3D-BB-MRI两种方法具有良好的一致性。结论 3D-BB-MRI和2D-BB-MRI对于定量评价颈动脉粥样硬化斑块方面无明显差异;3D-BB-MRI具有任意角度重建图像、灵活显示管壁及斑块情况的特点,我们认为3D-BB-MRI对于颈动脉粥样硬化成像较2D-BB-MRI具有更好的发展前景。Objective To assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging （3D-BB-MRI） in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood magnetic resonance imaging （2D-BB-MRI）. Methods Forty patients were scanned with routine 2D and oblique-sagittal 3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial2D-like dataset. Two experienced radiologists identified the interested slice in consensus for every patient （unilateral carotid artery） in 2D-BB-MRI images and matched the axial reformatted 3D images with 2D black-blood images. Plaque thickness （PT）, lumen area （LA） and total vessel area （TVA） were measured, and lumen stenosis （LS） and normalized wall index （NWI） were calculated. Results There was no measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI （P〉0.05）, and these two methods had a good correlation （r〉0.9）. The Bland-Airman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the measurement of PT, LA and TVA. Conclusion 3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.

关 键 词：高分辨黑血磁共振成像技术 颈动脉粥样硬化 斑块 

分 类 号：R445.2[医药卫生—影像医学与核医学]