多模态MRI在症状性动脉粥样硬化性颅内动脉狭窄诊断中的应用  

Application of Multi Modality MRI in the Diagnosis of Symptomatic Atherosclerotic Intracranial Artery Stenosis

作　　者：黄晓星[1] 凌文通[1] 肖学红[1] 杨昂[1] 王志龙[1] 曾淑妍[1] 

机构地区：[1]中山大学附属中山医院(中山市人民医院),广东中山528400

出　　处：《中国CT和MRI杂志》2017年第3期1-3,6,共4页Chinese Journal of CT and MRI

基　　金：中山市科学技术局项目;编号:2016J027

摘　　要：目的探讨预测症状性动脉粥样硬化性颅内动脉狭窄(s ICAS)患者采用支架植入术疗效的多模态MRI指标,为此类患者的早期治疗及治疗方案的确定提供依据。方法以就诊于我院的重度s ICAS患者120例为研究对象,随机分为对照组与观察组各60例。所有入组患者治疗前完善MRI检查(常规MRI+MRA、PWI、高分辨率磁共振斑块成像)。对照组给予常规内科治疗,观察组在常规内科治疗基础上加用血管内支架成形术。所有患者随访1年。比较治疗前及随访12个月时两组患者的并发症发生率、卒中复发率、平均通过时间(MTT)、脑血容量(CBV)、灌注达峰时间(TTP)及脑血流量(CBF),分析影像学各指标与治疗方案的相关性。结果与治疗前相比,两组的MTT显著降低,CBV及CBF明显升高,TTP明显降低,差异均具有统计学意义(P<0.05);与对照组相比,观察组的MTT显著降低,CBV及CBF明显升高,卒中复发率明显降低,差异均具有统计学意义(P<0.05)。结论血管内支架植入术降低了卒中复发率,多模态MRI灌注成像的相关指标可用于评估s ICAS支架植入术的疗效。Objective Prediction of symptomatic atherosclerotic intracranial arterial stenosis （sICAS） were treated with the efficacy ofstent implantation image sensitive index, in order to provide the basis for the determination of such patients, early treatment and treatment scheme.Methods 120 cases of severe slCAS in our hospital were randomly divided into the control group and the observation group, 60 cases in each group. Before treatment, al1 patients were treated with perfect MRI examination （conventional MRI＋MRA, PWI, high resolution magnetic resonance imaging）. The control group was given routine Department of internal medicine treatment, and the observation group was treated with endovascular stent assisted angioplasty. All patients were followed up for 1 years. Compared with before treatment and were followed up for 12 months of complications in two groups of patients with occurrence rate, strolce recurrence rate, mean through time （MTT）, brain blood volume （CBV） and cerebral blood flow （CBF） and image analysis correlation of each index and treatment options. Results Compared with before treatment, two groups of MTT decreased significantly, CBV and CBF increased significantly compared with statistical significance （P〈0.05）, compared with the control group, observation group of MTT decreased significantly, CBV and CBF increased significantly, stroke recurrence rate was significantly lower compared with statistical significance （P〈0.05）. Conclusion Endovascular stent implantation can reduce the recurrence rate of Stroke, and multi modaliW MRI perfusion imaging can be used to evaluate the degree of stenosis of symptomatic atherosclerotic intracranial arteries.

关 键 词：多模态 磁共振 颅内动脉狭窄 

分 类 号：R543.5[医药卫生—心血管疾病] R445.2[医药卫生—内科学]