颈动脉粥样硬化疾病评分与高分辨率磁共振成像特征关系研究  

Relationship between carotid atherosclerosis score and its high-resolution MRI characteristics

作　　者：韩旭 赵锡海[2] 崔豹[3] 马露[3] 蔡剑鸣[3] 

机构地区：[1]航天中心医院放射科,北京100049 [2]清华大学生物影像研究中心 [3]解放军总医院放射诊断科

出　　处：《中华老年心脑血管病杂志》2018年第2期117-121,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨脑缺血患者颈动脉粥样硬化疾病评分(CAS)与颈动脉粥样硬化疾病及临床指标的相关性。方法选取近期(<2周)脑梗死或短暂性脑缺血发作的患者96例进行颈动脉高分辨MRI检查。测量颈动脉斑块所致的管腔狭窄、最大管壁厚度及斑块累及范围。选取颈动脉斑块内仅含富脂质核不稳定成分的图像,使用CASCAD软件进行分析,计算CAS值,根据CAS值分为低危组和高危组。分析CAS与临床指标的相关性。结果 96例患者检测到148支颈动脉斑块内仅含富脂质核,平均CAS值(21.6±17.5)%,其中CAS 1级29支、2级52支、3级41支、4级26支。CAS值与颈动脉管腔狭窄、管壁最大厚度及斑块累及范围呈正相关(r=0.610、r=0.569和r=0.527,P<0.01)。不同CAS级别颈动脉管腔狭窄、最大管壁厚度及斑块累及范围差异有统计学意义(P<0.01)。CAS值与LDL及HDL/TG比值相关(r=0.469,P<0.01;r=-0.269,P<0.05);高危组收缩压、舒张压及LDL水平较低危组明显升高(P<0.05)。结论 CAS与颈动脉粥样硬化疾病关系密切,且与脂质代谢相关。CAS级别越高,未来颈动脉斑块发生出血及纤维帽破裂的可能越大。Objective To study the relationship of carotid atherosclerosis score （CAS） with carotid atherosclerotic disease and its clinical indexes in isehemic stroke patients. Methods Ninety-six patients with ischemic stroke （〈2 weeks） or transient ischemic attack underwent high-resolution MRI of bilateral carotid arteries to measure their carotid atherosclerotic luminal stenosis,maximal wall thickness （MaxWT） and plaque involvement size. The carotid plaque images with unstable components of lipid-rich core （LRC） were analyzed with CASCAD software. The CAS value was calculated and divided into low risk group and high risk group. The relationship between CAS and its clinical indexes was analyzed. Results LRC was detected in plaques of 148 carotid arteries of the 96 patients with a CAS value of 21.6%4-17.5%. The CAS value was related with the carotid luminal stenosis,MaxWT and plaque involvement size （r=0. 610,r=0. 569,r=0. 527,P〈 0. 001）. A significant difference was found in carotid luminal stenosis, MaxWT and plaque in- volvement size with a different CAS value （P〈0.01）. The CAS value was related with LDL and HDL/TC ratio （r=0. 469,P〈0.01;r=-0. 269,P=0. 035）. The SBP,DBP and LDL level were higher in high risk group than in low risk group （P〈0.05）. Conclusion CAS is closely related with carotid atherosclerotic disease and lipid metabolism. The higher the CAS value is,the higher the risk of carotid plaque hemorrhage and fibrous cap rupture is.

关 键 词：颈动脉疾病 脑缺血 动脉粥样硬化 颈动脉狭窄 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]