MRI高分辨技术对复发性脑梗死患者颈动脉斑块特点的诊断价值  

Value of High-resolution MRI in the Diagnosis of Carotid Plaque in Patients with Recurrent Cerebral Infarction

作　　者：李建灵[1] 殷洁[1] LI Jian-ling;YIN Jie(Department of MRI Room,the Cental Hospital of Nanyang City,Nanyang 473000,Henan Province,China)

机构地区：[1]河南省南阳市中心医院磁共振室,河南南阳473000

出　　处：《中国CT和MRI杂志》2018年第9期73-75,82,共4页Chinese Journal of CT and MRI

摘　　要：目的分析M R I高分辨技术(HRMRI)对复发性脑梗死患者颈动脉斑块特点的诊断价值。方法选取2015年4月至2018年4月我院收治的脑梗死患者262例为研究对象,其中复发性脑梗死者纳入研究组(n=162,检出斑块165个),初发性脑梗死者纳入对照组(n=100,检出斑块105个),均于发病1周内行HRMRI检查,获得3D-TOF、高分辨率MRI黑血序列及CE-T1WI序列图像,对比两组所得图像,并以超微血流成像检查为准,分析HRMRI诊断颈动脉易损斑块的效能。结果研究组HRMRI下不稳定斑块检出率41.82%明显高于对照组28.57%(P<0.05);研究组管壁标准化指数(NWI)及斑块内出血(IPH)、斑块纤维帽破裂发生率高于对照组(P<0.05);以超微血流成像检查为准,HRMRI诊断复发性脑梗死患者颈动脉易损斑块的灵敏度、特异度、准确度、阳性预测值、阴性预测值、kappa一致性分别为95.35%、85.33%、88.52%、75.23%、97.52%、0.753。结论 HRMRI可较好评估复发性脑梗死患者颈动脉斑块性质及血管腔狭窄情况,检出易损斑块,值得在临床推广实践。Objective To analyze the value of high resolution MRI （HRMRI） in the diagnosis of carotid plaque in patients with recurrent cerebral infarction. Methods A total of 262 patients with cerebral infarction who were treated in the hospital from April 2015 to April 2018 were selected as the subjects. Among them, patients with recurrent cerebral infarction were included in the study group （n=162, 165 plaques） and patients with primary cerebral infarction were included in the control group （n=100, 105 plaques）. All patients underwent HRMRI within 1 week after onset, and images of 3D-TOF, high-resolution MRI black blood sequence and CE-T1WI sequence were obtained. The images were compared between the two groups, and with results of ultramicro blood flow imaging examination as the standard, the efficiency of HRMRI in the diagnosis of vulnerable carotid plaque was analyzed. Results The detection rate of unstable plaques by HRMRI in the study group was significantly higher than that in the control group （41.82% vs 28.57%） （P〈0.05）. The normalized wall index （NWI）, incidence rates of intra-plaque hemorrhage （IPH） and fibrous cap rupture in the study group were higher than those in the control group （P〈0.05）. With results of ultramicro blood flow imaging examination as the standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and kappa consistency of HRMRI in the diagnosis of vulnerable carotid plaque in patients with recurrent cerebral infarction were 95.35%, 85.33%, 88.52%, 75.23%, 97.52% and 0.753, respectively. Conclusion HRMRI can better evaluate the nature of carotid plaques and the state of vascular stenosis in patients with recurrent cerebral infarction and detect vulnerable plaques.

关 键 词：MRI高分辨技术 复发性脑梗死 颈动脉 斑块 诊断价值 

分 类 号：R543.4[医药卫生—心血管疾病]