基于MR定量积分及血液动力学参数评价颈动脉粥样硬化同脑梗死的相关性  

Evaluation of the correlation of carotid atherosclerosis and cerebral infarction based on MR quantitative score,and the hemodynamic parameters

作　　者：陆文杰[1] 肖正光[1] 顾峰[1] 闵庆华[1] 尚鸣异[1] 朱才松[1] 袁立新[1] 杨军[1] LU Wenjie;XIAO Zhengguang;GU Feng;MIN Qinghua;SHANG Mingyi;ZHU Caisong;YUAN Lixin;YANG Jun(Department of Radiology,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Xianxia Road,Shanghai 200336,P,R,Chin)

机构地区：[1]上海市同仁医院上海交通大学医学院附属同仁医院影像介入科,上海200336

出　　处：《医学影像学杂志》2018年第6期903-907,共5页Journal of Medical Imaging

基　　金：上海市长宁区科委及上海市同仁医院基金联合资助(编号:CNKW2015Y07)

摘　　要：目的本研究利用磁共振相位对比等序列联合对颈动脉粥样硬化斑块数量、大小及血流情况进行量化评价,探讨其同脑梗死发生的相关性。方法收集2014年1月～2015年12月我院神经内科住院患者207例,排除6例,分为无梗死组(88例)、小血管型梗死(54例)、大动脉型梗死(59例),应用3.0T磁共振行双侧颈动脉检查并获得相关积分,以及颈动脉的流速、流量等参数,对比分析各组间的差异,绘制ROC曲线以评价颈动脉斑块积分对脑梗死的诊断价值。结果 Course积分大动脉型梗死组(1.99±1.99)明显高于无梗死组(1.04±1.11)和小血管型组(1.49±1.26),存在显著差异(P<0.05),两个梗死组间、小血管型梗死组和无梗死组之间不存在显著差异。半定量积分各组间统计学无明显差异。两种积分ROC曲线分析,Course曲线下面积大于半定量积分。无梗死组颈动脉峰值流速高于小血管型及大动脉型梗死组,各组间存在显著差异(P<0.05)。大动脉型梗死组流量降低明显,同无梗死组和血管型梗死组间差异显著,小血管型梗死组和无梗死组无显著差异。结论 Course积分升高、颈动脉流速、流量降低同大动脉型脑卒中有较强的相关性,对高危颈动脉粥样硬化患者的筛查有较高意义。Objective Our study is to evaluate carotid artery atherosclerosis plaque quantity, size and blood flow quantitatively, using noninvasive techniques of conventional MR imaging sequences, and its correlation with cerebral infarction. Methods 207 hospitalized patients in the Department of neurology were collected from January 2014 to December 2015, six cases were excluded. They were divided into no infarction group （88 cases）, small vascular infarction （54 cases）, vascular infarction （59 cases）. All patients underwent bilateral carotid artery to get plaque and the carotid artery flow velocity, flow parameters with 3.0 T MRI, comparative analysis of the differences between groups, ROC curve drawing to evaluate carotid artery plaque integral value to the diagnosis of cerebral infarction. Results Course of vascular infarction group （1.99±1.99） was significantly higher than no infarction group （1.04±1.11） and small vascular group （1.49±1.26） （ P 〈0.05）, there was no significant difference between two infarction group and small vascular infarction group and no infarction group. Semi-quantitative score statistics had no discernible differences between groups. For Ros ROC curve analysis, course area under the curve was greater than the semi-quantitative score. Carotid artery peak flow velocity without infarction group was higher than the small blood vessels and artery infarction group. There were significant differences between groups （ P 〈0.05）. Flow reduced obviously in vascular infarction group, and with significant difference between no Infarction group and small vascular infarction group, there was no significant difference between small vascular infarction group and no infarction group. Conclusion Course integral elevation, carotid flow velocity and flow rate are related to vascular infarction. This is useful for screening high-risk patients with carotid atherosclerosis.

关 键 词：磁共振成像 颈动脉粥样硬化 定量 血液动力学 脑梗死 

分 类 号：R541.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]