SWI评估高血压患者心血管危险分层与脑内微出血相关性的研究  

Sluoly on correlation between cardiovascular risk stratification and cerebral microbleeds in hypertension patients using susceptibility weighted imaging

作　　者：张国华[1] 郑素君[2] 郑海澜[1] 陈运奎 

机构地区：[1]浙江省台州市第一人民医院放射科,浙江台州318020 [2]浙江省台州市第一人民医院泌尿科,浙江台州318020

出　　处：《医学影像学杂志》2014年第1期25-28,共4页Journal of Medical Imaging

基　　金：浙江省科技厅项目(2012C33099)

摘　　要：目的应用磁敏感加权成像（SWI）评估高血压患者脑内微出血与高血压血管危险分层是否存在相关性的研究。方法按照研究纳入标准对150例临床诊断高血压患者作心血管危险分层：低危、中危、高危、极高危；运用1．5TMR扫描仪进行常规MRI序列和SWI序列进行扫描，检查结果由本院两位磁共振医生进行回顾性分析。分析SWl序列上不同心血管危险分层高血压患者脑内微出血（CMBs）表现（SWl上CMBs为直径2-5mm的圆形低信号区），统计并确定CMBs的位置和数量：依据CMBs所在的部位（即皮质一皮质下区，基底核、丘脑、脑干、小脑）确定CBMs的位置，并计算各部位CMBs的数量。结果SwI序列检出颅内微出血427个，其中高血压低危（83个）、中危（94个）、高危（113个）、极高危（137个），不同级别高血压患者心血管危险分层不同、脑内微出血病灶数量之间的差异具有统计学意义（x2=9．92，P〈O．05）。微出血病灶分布于基底节区为（152个，35．6％）．皮层一皮层下为（43个，10．1％）、脑干为（49个，1i．5％）、丘脑为（132个，30．8％）、小脑为（51个，12．o％），脑微出血病灶在脑内各个区域都有分布，以基底节区及丘脑好发。结论高血压患者血管危险分层与脑内微出血数量存在着正相关。Objective To evaluate the correlation between cardiovascular risk stratification and cerebral microbleeds （CMBs） in hypertension patients using susceptibility weighted imaging （SWI）. Methods 150 hypertension patients satis- fied the study inclusion criteria were classified as low risk, medium risk, high risk and very high risk, basing on the cardi- ovascular risk stratification. Routine MRI sequences and SWI sequences were scanned using the 1.5 T MR scanner and the examination results were analyzed retrospectively by two doctors in our hospital. The CMBs photography manifestation was defined as round shape and low signal area with the diameter of 2~5 mm in SWI. The position and quantity of CMBs of different cardiovascular risk stratification was determined according to the area, including cortical-subcortical area, basal nucleus, thalamus, brainstem and cerebellum. Results 427 CMBs were detected in SWI sequence, of which 83 were low risk, 94 were medium risk, 113 were high risk and 137 were very high risk. There was significant difference in the quanti- ty of CMBs in different cardiovascular risk stratification （X2 = 9.92, P 〈0.05）. All the brain regions had CMBs distribu-tion, including basal ganglia （ 152,31.6 % ）, cortical-suhcortical area （43,10. 1 % ）, brainstem （49, 11.5 %）, thalamus （132,30.8 %0）, cerebellum （51,12.0%）, and appeared mostly in the basal ganglia and thalamus. Conclusion There is a positive correlation between cardiovascular risk stratification and the quantity of CMBs in hypertension patients.

关 键 词：高血压 血管危险分层 脑微出血 磁敏感加权成像 

分 类 号：R544.1[医药卫生—心血管疾病]