MRI3D-SPACE探讨基底动脉斑块位置和增强度与梗死的关系  

Exploration of the relationship between the enhancement degree and location of basilar artery plaque and infarction with MRI3D-SPACE

作　　者：张红梅[1] 孙雪园 陈新[1] 牛琰鑫[1] 

机构地区：[1]第二炮兵总医院医学影像科,北京100088

出　　处：《医学影像学杂志》2016年第2期189-193,共5页Journal of Medical Imaging

摘　　要：目的应用3T MRI（3T magnetic resonance imaging,MRI）,三维快速自旋回波（3D sampling perfection with application-optimized contrasts using different flip angle evolutions,3D-SPACE）序列显示症状性动脉粥样硬化患者基底动脉管壁硬化斑块,通过斑块形态学特征及增强度,评估其与梗死的关系。方法 103例症状性后循环缺血患者行3D-SPACE序列扫描,测量基底动脉斑块及邻近正常脑灰质信号强度,二者得出基底动脉斑块相对增强度,且划分为：轻度强化（1%-10%）、中度强化（10%-100%）、明显强化（100%以上）;研究急性联合亚急性梗死（A组）、慢性及无梗死（B组）与基底动脉斑块相对增强度的关系。DWI图像评估有无近期梗死灶。结果 100例有症状患者纳入统计,急性梗死46例、亚急性梗死26例、慢性期梗死15例、无梗死13例。梗死部位包括脑干、桥臂、小脑半球、枕叶、中脑、丘脑及延髓。3DSPACE序列能多角度显示基底动脉斑块,偏心性斑块70例,且斑块位于基底动脉腹侧壁更易发生梗死;斑块相对增强度〉100%更易发生梗死;急性联合亚急性梗死（A组）、慢性及无梗死（B组）两组之间斑块增强度比较存在差异;在脑梗死分期时斑块明显强化与轻度强化、中度强化之间有统计学意义（P值〈0.005）。结论 3D-SPACE序列能在较短时间内更全面评估基底动脉斑块形态及增强特征与脑梗死之间的关系,二者的关系可以作为临床脑梗死诊断及鉴别诊断的依据。Objective By use of 3T 3D-SPACE sequence,to reveal atherosclerotic plaquesplaque of basal arterial wall in patients with symptomatic atherosclerosis,and to assess its relationship with the newly infarction via the plaque morphological features and enhanced degrees. Methods 103 patients with symptomatic with posterior circulation ischemia were subjected to 3DSPACE sequence,the signal strength of the basal artery plaque and adjacent normal brain gray matter was measured,and the relative strengthening of basilar artery plaque was obtained,which was divided into： mild（ 1% - 10%）,moderate enhancement（ 10% - 100%）,and significant enhancement（〉 100%）. Then,the relationship between both acute joint subacute infarction（ group A）,chronic and no infarction（ group B） with basilar artery plaque enhancement degree was studied. DWI image was used to assess whether the recent infarcts occurred or not. Results Of those 100 patients who were included in the statistics,46 were suffered from acute infarction,26 from subacute infarction,and 15 from chronic infarction,and 13 had no infarction. The infarct parts included the brain stem,bridge arm,cerebellum,occipital lobe,the midbrain and hypothalamus and medulla oblongata. 3 D-SPACE sequence can display the basal artery plaque with multi-angle. 70 cases presented with partial eccentricity plaque,and for the plaque located in basilar artery abdominal wall,the infarction was more apt to occur. Infarction occurred more often in the plaque with relative enhancement degree 〉100%. The plaque enhanced degrees between Group A and B had statistical significance. Conclusion 3D-SPACE sequence can comprehensively assess the relationship between morphology of basilar artery plaque and enhanced features in a relatively short time,which can be used as a basis for the clinical diagnosis and differential diagnosis of cerebral infarction.

关 键 词：基底动脉 斑块 磁共振成像 

分 类 号：R743.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]