症状性颅内动脉粥样硬化斑块易损性的直方图纹理分析  

Histogram texture analysis on vulnerability of symptomatic plaques in intracranial atherosclerosis

作　　者：史张 陈海虎[1] 李晶[1] 田霞[1] 张雪凤[1] 彭雯佳[1] 陈录广[1] 陆建平[1] 王莉[1] 刘崎[1] SHI Zhang;CHEN Hai-hu;LI Jing;TIAN Xia;ZHANG Xue-feng;PENG Wen-jia;CHEN Lu-guang;LU Jian-ping;WANG Li;LIU Qi(Department of Radiology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China)

机构地区：[1]第二军医大学附属长海医院影像医学科,上海200433

出　　处：《磁共振成像》2018年第3期186-191,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81670396;31470910);上海市市级医院新兴前沿技术联合攻关项目(编号:SHDC12013110);全军医学科研"十二五"计划重点课题(编号:BWS12J026)~~

摘　　要：目的本研究通过比较颅内动脉粥样硬化斑块的形态学及直方图纹理特征的差异,进一步分析症状性斑块的特征。材料与方法 2016年1月至2017年1月对可疑脑卒中患者及部分体检者进行颅内动脉管壁HR-MRI。用CMRTools及Image J 14.0软件测量各个序列上病变最狭窄处斑块的特征值。采用Logistic回归模型进行统计学分析。结果 133例受试者[平均年龄(58.5±11.4)岁]中急性缺血性卒中患者75例,无症状者58例。在T2WI及T1WI增强序列中直方图的特征值无统计学差异。Logistic回归分析发现斑块的最小管腔面积(minimal luminal area,MLA。OR=1.301;95%CI,1.036~1.633)、斑块内出血(intraplaque hemorrhage,IPH。OR=12.440;95%CI,1.551~99.780)和变异系数(coefficient of variation,CV。OR=3.476;95%CI,1.513~7.985)是脑血管事件发生的危险因素。ROC曲线显示三个特征结合起来共同评判斑块易损性时,其曲线下面积可达0.801。结论在非增强的T1WI上定量直方图纹理分析法可以用来鉴别急性症状性颅内动脉粥样硬化斑块与无症状性斑块,而且直方图分析法较之前的形态学分析法对斑块易损性的判别有更高的价值。Objective:The aim of the present study is to evaluate differences in histogram features between symptomatic and asymptomatic plaques in intracranial atherosclerotic disease on HR-MRI.Materials and Methods:This study population was retrospectively selected from patients with intracranial stenosis who underwent intracranial HR-MRI between January 2016 and January 2017,from whom all of the plaque features were extracted using CMR Tools and Image J software.Statistical analysis was performed using a logistic regression model.Results:A total of 133 plaques were identified in the 133 patients(mean age 58.5±11.4 years),of which 75 patients were considered with acute ischemic stroke and 58 patients were asymptomatic.T1 images would have a higher sensitivity to predict the vulnerability of atherosclerotic plaques by the quantitative histogram analysis compared with T2 and T1-enhancement images.Multiple logistic regression analysis showed that MLA(OR=1.301,95%CI,1.036-1.633),IPH(OR=12.440,95%CI,1.551-99.780)and CV(OR=3.476,95%CI,1.513-7.985)were important predictors to define symptomatic plaques.Both the morphological and histogram features had been combined to classify the intracranial atherosclerotic plaques was better than the method on the single way,where the area under the curve(AUC)of ROC curve was 0.801.Conclusions:This study demonstrated that quantitative histogram analysis based on T1WI without enhancement could help distinguish acute symptomatic from asymptomatic plaques in intracranial atherosclerosis,and it is better than traditional method to differentiate acute symptomatic and asymptomatic intracranial atherosclerotic plaques.

关 键 词：颅内动脉粥样硬化 磁共振成像 脑卒中 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.1[医药卫生—诊断学]