基于HR-MRI对轻度狭窄的基底动脉斑块特征与临床症状关系的研究  

Study of the relationship between the characteristics of basilar artery plaque with mild stenosis and clinical symptoms based on HR-MRI

作　　者：王旭超 徐敏[1] 孙兆男 徐畅[1] 王巍[1] WANG Xuchao;XU Min;SUN Zhaonan;XU Chang;WANG Wei(Department of Magnetic Resonance,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一临床医学院磁共振科

出　　处：《磁共振成像》2019年第8期561-565,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的利用高分辨磁共振成像(high-resolution magnetic resonance imaging,HRMRI)管壁成像对轻度狭窄的基底动脉的症状性患者和非症状性患者之间的斑块分布、成分及相关临床特点进行分析。材料与方法在三维时间飞跃法磁共振血管造影(threedimension time of flight magnetic resonance angiography,3D-TOF-MRA)、磁共振扩散加权成像(diffusion weighted imaging,DWI)、液体衰减反转恢复(fluid attenuated inversion recovery,FLAIR)扫描序列的基础上,经HR-MRI管壁成像后,将确定有基底动脉轻度狭窄(<50%)且存在斑块的患者纳入研究。根据临床表现、卒中时间及影像学表现,分为症状组(近3个月内发生的与后循环相关的缺血症状或短暂性脑缺血发作,并在DWI或FLAIR像上观察到相应的病变)和非症状组(无后循环脑血管病发作史,无MRI平扫阳性表现),对两组患者间基底动脉斑块的分布(腹侧壁、侧壁、背侧壁)、成分[斑块内出血(intraplaque hemorrhage,IPH)、纤维帽断裂(fibrous cap rupture,FCR)]以及相关临床特点进行分析。结果108例基底动脉轻度狭窄且伴有斑块的患者(症状组47例,非症状组61例)、3244幅图像被研究,其中306幅图像中含有斑块(不同序列相同切面的斑块定义为一幅),共计413个斑块(连续累及两个或两个以上切面的斑块计为一个),症状组192个,无症状组221个。症状组中的侧壁斑块所占比例(45.8%)与无症状组(47.5%)相似,两者之间差异无统计学意义(P=0.733);症状组中背侧壁斑块所占比例(33.9%)较无症状组(19.0%)大,差异有统计学意义(P=0.001);症状组中腹侧壁斑块所占比例(20.3%)较无症状组(33.5%)小,差异有统计学意义(P=0.003)。症状组中IPH(58.9%)及FCR(55.7%)所占比例均大于无症状组(分别为44.3%、45.2%),差异均有统计学意义(P=0.003、0.034)。两组之间的相关临床因素[年龄、性别、高血压史、糖尿病史、是否血脂异常、吸烟史、饮酒史、体质�Objective:HR-MRI magnetic resonance imaging was used to analyze the plaque distribution,plaque composition and relevant clinical characteristics between symptomatic patients and asymptomatic patients with mild stenosis of the basilar artery.Materials and Methods:Patients with mild basilar artery stenosis(<50%)and plaques were confirmed to be included in the study after HR-MRI tube wall imaging on the basis of three-dimension time of flight magnetic resonance angiography(3D-TOF-MRA),diffusion weighted imaging(DWI)and fluid attenuated inversion recovery(FLAIR)scanning sequences.According to clinical manifestations,stroke duration and imaging manifestations,the patients were divided into the symptom group(ischemia symptoms or TIA related to posterior circulation occurred in the last 3 months,and corresponding lesions were observed on DWI or FLAIR images)and the non-symptom group(no history of posterior circulation cerebrovascular disease,no MRI positive scan),Plaque distribution,plaque composition[intraplaque hemorrhage(IPH),fibrous cap rupture(FCR)]and relevant clinical characteristics of the basilar artery between the two groups were analyzed.Results:In 108 patients with mild basilar artery stenosis accompanied by plaques(47 patients in the symptom group and 61 patients in the non-symptom group),3244 images were studied,and it was found that 306 images contained plaques(plaques with the same slice of different sequences were defined as one),a total of 413 plaques(A plaque that continuously affects two or more slices is counted as one),192 in the symptom group and 221 in the asymptomatic group.The proportion of side wall plaques in the symptomatic group(45.8%)was similar to that in the asymptomatic group(47.5%),and there was no statistical difference between the two groups(P=0.733).The proportion of dorsal plaques in the symptomatic group(33.9%)was larger than that in the asymptomatic group(19.0%),and the difference was statistically significant(P=0.001).The proportion of ventral plaques in the symptomatic group(20

关 键 词：基底动脉 卒中 斑块 动脉粥样硬化 高分辨磁共振成像 

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]