3D颅颈联合血管壁成像评估动脉粥样硬化的可重复性研究  

Scan-Rescan Reproducibility of 3D Joint Intra-and Extra-Cranial Vessel Wall Magnetic Resonance Imaging for Atherosclerosis Evaluation

作　　者：沈宓[1] 高培毅[1,2] 杜康 陈硕 SHEN Mi;GAO Peiyi;DU Kang;CHEN Shuo(Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China;Beijing Neurosurgical Institute,Beijing 100050,China;Department of Biomedical Engineering,School of Medicine,Tsinghua University,Beijing 100084,China)

机构地区：[1]首都医科大学附属北京天坛医院放射科,北京100050 [2]北京市神经外科研究所,北京100050 [3]清华大学医学院生物医学工程系,北京100084

出　　处：《中国医疗设备》2018年第9期32-36,41,共6页China Medical Devices

基　　金：国家自然科学基金(81361120402;81301193);北京市自然科学基金资助项目(7162056;7133238)

摘　　要：目的对3D颅颈联合血管壁成像显示颈动脉及大脑中动脉的动脉粥样硬化特点(形态、斑块成分)的可重复性进行评估。方法入组颈动脉或大脑中动脉存在动脉粥样硬化斑块的症状性大脑中动脉供血区梗死患者10例。所有患者均行两次3D颅颈联合血管壁成像,时间间隔小于1个月。对所有患者双侧颈总动脉段、颈动脉窦段、颈内动脉C1段(C1)、颈内动脉C2~C7段(C2~C7)及大脑中动脉M1段进行评估,评估包括斑块存在、管腔面积、管壁面积、最大管壁厚度、血管狭窄程度、斑块面积、斑块分布、斑块成分(颈动脉:斑块内出血、钙化、溃疡;大脑中动脉:斑块分布、斑块内出血),并比较两次扫描对斑块定性及定量评估的差异。结果排除1例图像质量差的患者,共9例患者,72个颈动脉节段和18个大脑中动脉节段被纳入分析。共14个颈动脉斑块和8个大脑中动脉斑块被检出,统计结果显示两次扫描对管腔面积、管壁面积、最大管壁厚度、血管狭窄程度、斑块面积等参数的评估一致性良好(ICC均大于0.75)。对于颈动脉脉斑块存在、钙化、溃疡及大脑中动脉斑块存在、分布及斑块内出血等性质的评价一致性极好(Kappa值均大于0.8),对于颈动脉斑块内出血的评估具有良好的一致性(Kappa值大于0.6)。结论 3D颅颈联合血管壁成像具有良好的可重复性,能够用于评估颈动脉及大脑中动脉的动脉粥样硬化斑块的特点,具有良好的临床应用前景。Objective To evaluate the reproducibility of scan-rescan reproducibility of 3D joint intra- and extra-cranial vessel wall magnetic resonance imaging for atherosclerosis characteristics （morphology and component） evaluation. Methods A total of 10 symptomatic patients with ischemic infarction in middle cerebral artery （MCA） region with carotid or MCA atherosclerosis were recruited. All patients were scanned twice within one month with 3D joint intra- and extra-cranial vessel wall imaging. Plaque presence, lumen area （LA）, wall area （WA）, maximum wall thickness （MWT）, stenosis, plaque area （PA）, plaque distribution, as well as plaque components such as intraplaque hemorrhage （IPH）, calcifcation （CA）, ulceration of carotid, plaque distribution （IPH） of MCA were evaluated for bilateral common carotid artery （CCA）, carotid Bulb, C1 and C2-C7 segments of internal carotid artery and M1 segment of MCA. Results After exclusion of 1 patient with poor image quality, 72 carotid segments and 18 MCA segments from 9 patients were evaluated. A total of 14 carotid and 8 MCA plaques were identifed. Good correlation （ICC〉0.75） were found in LA, WA, MWT, stenosis and PA evaluation. Near-perfect （Kappa〉0.8） agreement was found in presence, CA and ulceration of carotid plaque, and presence, distribution and IPH of MCA plaque. Substantial agreement （0.8〉Kappa〉0.6） agreement were found in carotid IPH detection. Conclusion This study shows high reproducibility of 3D joint intra- and extra-cranial vessel wall magnetic resonance imaging for atherosclerosis evaluation which has good clinical application prospects.

关 键 词：动脉粥样硬化 大脑中动脉 颈动脉 可重复性 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]