磁共振单次扫描多组织对比序列对颈动脉粥样硬化斑块评价的临床初步研究  

Role of MR multi-contrast atherosclerosis characterization sequence in assessment of carotid atherosclerotic plaques

作　　者：杨利新[1] 于薇[1] Fan ZY Xie YB 王占宏[1] Bi XM 安靖 张天静 Li DB 

机构地区：[1]首都医科大学附属北京安贞医院影像科,100029 [2]美国洛杉矶西达斯西奈医院生物研究室 [3]美国洛杉矶加利福尼亚大学生物工程系 [4]美国洛杉矶西门子研发部 [5]西门子(深圳)磁共振有限公司

出　　处：《中华老年心脑血管病杂志》2015年第11期1129-1132,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81071196);卫生公益性行业科研专项项目(201402019);北京市卫生系统高层次卫生技术人才培养计划项目(2013-2-005)

摘　　要：目的评价MR 3D单次扫描多组织对比序列(MATCH)定量评价颈动脉血管形态学和定性评价斑块内成分的价值。方法选择超声检查发现颈动脉狭窄>50%且拟行颈动脉内膜剥脱术患者30例,术前分别行MATCH(5min)及MRI常规多序列扫描(T1WI,T2WI,三维时间飞跃和质子密度加权像,18min),扫描范围以颈动脉分叉为中心覆盖全部斑块。用MRI-Plaque View软件分析斑块形态学参数:管腔面积(LA)、管壁面积(WA)、标准化管壁指数(NWI),定性评价斑块内成分,包括斑块内出血(IPH)、斑块钙化(CA)、斑块脂质核心(LRNC)。用Cohen kappa分析2种序列对斑块内成分定性的一致性。结果 30例患者双侧颈动脉入选898个图像层面,MATCH和常规序列LA[(36.27±24.23)mm2 vs(35.72±20.12)mm2,t=1.87,P=0.062],WA[(42.80±20.67)mm2 vs(43.64±24.87)mm2,t=1.74,P=0.082],NWI[(59.21±13.90)vs(59.81±13.96),t=1.80,P=0.072]无显著差异。MATCH与常规序列判断斑块内成分有中到高度的一致性(LRNC:κ值=0.840,CA:κ值=0.802,IPH:κ值=0.773)。结论 MATCH有可能成为评估颈动脉易损斑块成分及斑块破裂危险程度的新方法。Objective To study the role of MATCH in quantitative assessment of carotid artery morphology and in qualitative assessment of carotid atherosclerotic plaque compositions.Methods Thirty patients with their carotid artery stenosis〉50% detected by ultrasonography for carotid artery revascularization in our hospital were included in this study.The patients underwent preoperative carotid MRI,MATCH for 5min and routine multi-sequence scanning（RMSS）for 18 min to characterize their carotid atherosclerotic plaques.The plaque compositions（IPH,CA,LRNC）were qualitatively identified by analyzing the plaque morphology parameters（LA,WA,NWI）using the MRI-Plaque View Analyzing Software.Results No significant difference was found in LA,WA and NMI detected by MATCH and RMSS（36.27±24.23mm2 vs 35.72±20.12mm2,P=0.062;42.80±20.67mm2 vs 43.64±24.87mm2,P=0.082;59.21±13.90 vs59.81±13.96,P=0.072）.MATCH and RMSS showed a high consistency in characterization of plaque compositions（LRNC,CA,IPH：κ=0.840,0.802,0.773）.Conclusion MATCH may become a potential new method for assessing the compositions and rupture of carotid plaques.

关 键 词：颈动脉 磁共振成像 颈动脉狭窄 颈动脉内膜切除术 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]