3.0T高分辨磁共振评价脑缺血患者症状侧与非症状侧颈动脉粥样硬化性斑块的差异  

Differences of carotid atherosclerotic plaques between symptomatic and asymptomatic sides in cerebral ischemic patients detected using 3.0T high-resolution MR imaging

作　　者：韩旭[1] 刘丹青[1] 崔豹[1] 马露[1] 李依霞 蔡幼铨[1] 蔡剑鸣[1] 

机构地区：[1]解放军总医院放射诊断科,北京100853

出　　处：《解放军医学院学报》2014年第7期654-656,687,共4页Academic Journal of Chinese PLA Medical School

基　　金：全军"十二五"科研计划面上项目(CWS11J065)~~

摘　　要：目的采用3.0T高分辨磁共振成像评价脑缺血患者症状侧(患者一侧肢体出现脑缺血临床症状,对侧颈动脉则定义为症状侧)与非症状侧颈动脉粥样硬化斑块的差异。方法收集2012年6月-2013年6月本院脑梗死或短暂性脑缺血患者102例,2周内进行双侧颈动脉高分辨磁共振成像,分析症状侧与非症状侧颈动脉粥样硬化斑块的差异。结果 102例脑缺血患者中,脑梗死52例,短暂性脑缺血50例。症状侧与非症状侧颈动脉粥样硬化斑块所致颈动脉管腔狭窄程度比较无统计学差异(P>0.05),最大管壁厚度及斑块累及范围比较均有显著统计学差异(P=0.000);症状侧颈动脉粥样硬化斑块内易损成分(出血、富脂质核及纤维帽破裂)的发生率明显高于非症状侧,并且有显著统计学差异(Z=-6.525,P=0.000)。结论症状侧颈动脉粥样硬化斑块的严重性及易损性明显高于非症状侧斑块,症状侧斑块内易损成分发生率更高。Objective To investigate the differences of carotid atherosclerotic （AS） plaques between symptomatic and asymptomatic sides in cerebral ischemic patients detected using 3.0T high-resolution MR imaging. Methods One hundred and two patients with infarction or transient ischemic attack （TIA） in our hospital from June 2012 to June 2013 were recruited in our study. Each patient was received high-resolution MR examination of bilateral carotid arteries in two weeks. The differences of carotid atherosclerotic plaques between symptomatic and asymptomatic sides were investigated. Results Of the 102 cerebral ischemic patients, 52 had infarction and 50 developed TIA. Compared with the carotid atherosclerotic plaques between symptomatic and asymptomatic sides, the luminal stenosis showed no difference （P 〉 0.05） while the maximum wall thickness and lesion length had significant statistic differences （P=0.000）. The occurrence rates of vulnerable compositions such as hemorrhage, lipid-rich core and fibrous cap rupture in symptomatic sides were obviously higher than those in asymptomatic sides and showed significant statistic difference （Z=-6.525, P=0.000）. Conclusion The severity and vulnerability of carotid atherosclerotic plaque in symptomatic side are obviously higher than the asymptomatic side. The occurrence rates of vulnerable compositions in symptomatic sides are higher.

关 键 词：高分辨磁共振成像 颈动脉 粥样硬化斑块 脑缺血 

分 类 号：R543.4[医药卫生—心血管疾病]