高分辨率磁共振血管壁成像在基底动脉狭窄的临床应用  

preliminary application of high-resolution magnetic resonance vessel wall imaging in basilar artery stenosis

作　　者：陈旭高[1] 邹建勋[1] 叶国伟[1] 周理余[1] 项万青[1] 吴燕[1] CHEN Xugao;ZOU Jianxun;YE Guowei;ZHOU Liyu;XIANG Wangqing;WU Yan(Department of Radiology,The People’s Hospital of Lishui,Lishui 323000,P.R.China)

机构地区：[1]浙江省丽水市人民医院放射科

出　　处：《医学影像学杂志》2019年第9期1463-1466,共4页Journal of Medical Imaging

摘　　要：目的探讨高分辨率磁共振血管壁成像(HR-VWI)在基底动脉狭窄的应用价值。方法收治35例基底动脉狭窄患者,对基底动脉狭窄的磁共振血管壁成像表现特点进行分析。结果其中5例脑干梗塞,30例没有发生梗塞。5例患者中梗塞后的管腔狭窄程度为66%、68%、75%、78%、90%。梗塞前的管腔狭窄程度为56%、63%、65%、71%、77%。两者存在显著的差异。5例脑干梗塞患者的狭窄程度均大于50%,动脉硬化斑块呈明显的偏心性强化。其中1例基底动脉狭窄程度达90%,增强后左后血管壁呈小点状强化。30例没有发生梗塞患者的狭窄程度均小于50%,动脉硬化斑块未见明显的偏心性强化。结论高分辨率磁共振血管壁成像在显示基底动脉狭窄程度、动脉硬化斑块强化程度方面有重要价值。管腔狭窄程度大于50%,动脉硬化斑块明显强化的患者可能有潜在脑干梗塞的风险。早期发现基底动脉粥样硬化管壁改变并采取适当的干预措施,对于预防脑干梗塞具有重要临床意义。Objective To investigate the application value of high-resolution vessel wall imaging(HR-VWI)in basilar artery stenosis.Methods 35 patients with basilar artery stenosis,who were admitted to the department of neurology of The People’s Hospital of Lishui,were retrospectively analyzed from January 2015 to October 2018.The characteristics of HR-VWI for basilar artery stenosis were summarized and analyzed.Results Among them,5 cases had brainstem infarction and 30 cases had no infarction.The degree of lumen stenosis after infarction was 66%,68%,75%,78%and 90%,while before infarction,that was 56%,63%,65%,71%,77%of the 5 patients,which were statistically significant.The stenosis degree of all the 5 patients with brainstem infarction was more than 50%,and the atherosclerotic plaque showed obvious eccentric enhancement.The degree of basilar artery stenosis reached 90%,and the wall of the left posterior blood vessel showed small punctiform enhancement after enhancement occured in one case.In contrast,the stenosis degree of 30 patients without infarction was less than 50%,and there was no obvious eccentric enhancement of atherosclerotic plaque.Conclusion High-resolution magnetic resonance angiowall imaging is of great value in showing the degree of basilar artery stenosis and the degree of atherosclerotic plaque enhancement.Patients with the degree of lumen stenosis more than 50%and significantly enhanced atherosclerotic plaques may have a potential risk of brainstem infarction.Early detection of changes in the wall of basilar artery atherosclerosis and appropriate intervention measures are of great clinical significance in preventing brainstem infarction.

关 键 词：基底动脉 高分辨磁共振血管壁成像 狭窄 脑干梗塞 

分 类 号：R455.2[医药卫生—运动医学] R743.3[医药卫生—治疗学]