3D—MPRAGE及DWI序列评价颈动脉支架术前斑块内出血的研究  

With 3D-MPRAGE and DWI sequence evaluation of intraplaque hemorrhage before carotid artery stenting

作　　者：姚彬[1] 史宏璐[1] 王光彬[1] 杨丽[1] 郑兴月 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021 [2]山东省立医院

出　　处：《实用放射学杂志》2014年第11期1798-1801,共4页Journal of Practical Radiology

基　　金：山东省医药卫生科技发展计划项目（2011HZ089）.

摘　　要：目的利用磁共振T1加权三维磁化强度预备梯度回波序列（3D-MPRAGE）及扩散加权成像（DWI）序列评价颈动脉支架术前斑块内出血。方法32例经彩色多普勒超声检查怀疑颈动脉斑块存在的有症状患者并准备行颈动脉支架术前行3．0T颈动脉高分辨MR扫描，包括常规序列、3D-MPRAGE序列、DWI序列。根据3D-MPRAGE序列判断出血情况并分组，分别测出血及非出血组、出血组中出血及非出血部分平均ADC值。同时出血组患者术前均行脑DWI扫描。利用SPSS20软件作独立样本t检验分析。结果高分辨MRI共显示40个斑块，3D-MPRAGE序列显示14个出血斑块。出血组与无出血组斑块平均ADC值分别为（1233．5±283．5）×10^-6mm^2／s、（1688．9±449．6）×10^-6mm^2／s；2组ADC值差异有统计学意义（t=3．43，P〈0．05）。出血组中出血部分与非出血部分平均ADC值分别为（934．0±387．9）×10^-6mm^2／s、（1313．9±295．0）×10^-6mm^2／s；2组ADC值差异有统计学意义（t=2．92，P〈0．05）。出血组非出血部分与非出血组斑块ADC值差异有统计学意义（t=2．80，P〈0．05）。结论3D-MPRAGE序列及DWI序列可评价颈动脉支架术前斑块内出血并为临床预防脑卒中及时干预提供影像依据。Objective To assess intraplaque hemorrhage before carotid artery stenting （CAS） by use of 3D-MPRAGE and DWI sequence. Methods Thirty-two symptomatic patients who had carotid artery plaque suspected by color Doppler ultrasonography and prepared for CAS underwent 3. 0T carotid high-resolution MR scans, including regular sequence, T1-weighted gradient echo three-dimensional magnetization prepared （3D-MPRAGE） sequence, diffusion-weighted imaging （DWI） sequences. According to 3D-MPRAGE sequence hemorrhage and non-hemorrhage groups were divided, and measured the mean ADC values of the two groups, hemorrhage and non-hemorrhage part in the hemorrhage group. Meanwhile preoperative cerebral hemorrhage group underwent brain DWI scans. Independent samples t-test analysis was utilized by SPSS V20. 0 statistical software. Results High-resolution MRI displayed 40 plaques, fourteen hemorrhagic plaques showed by 3D-MPRAGE sequence. The mean ADC values of hemorrhage and nohemorrhagegroupwere（1233.5±283.5） ×10^-6mm^2/s, （1 688.9 ± 449.6）× 10^-6mm^2/s respectively,the difference of bothwas significant （t= 3.43, P〈0. 05）. The mean ADC values of hemorrhage and non-hemorrhage parts in the hemorrhage group mean ADC values were （934. 0 ± 387. 9） × 10^-6 mm^2 / s , （1 313. 9 ± 295. 0） × 10^-6 mm^2/ s respectively; the difference of both was statistically significant （t = 2. 92, P〈 0. 05 ） . The difference of mean ADC values between non-hemorrhage part in the hemorrhage group and hemorrhage group was statistically significant （t= 2.80, P〈0. 05）. Conclusion 3D-MPRAGE and DWI sequences can be evaluated intraplaque hemorrhage before CAS, and provided a reliable basis for timely clinical interventions to prevent stroke.

关 键 词：颈动脉斑块内出血 扩散加权成像 3D-MPRAGE 颈动脉支架术 

分 类 号：R543.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]