颅内动脉狭窄斑块特征与缺血性卒中的关系  

The relationship between plaque characteristics of intracranial artery stenosis and ischemic stroke

作　　者：吴静静 贾琳[1] 王云玲[1] 韩秉艳[1] 贾文霄[2] WU Jingjing;JIA Lin;WANG Yunling;HAN Bingyan;JIA Wenxiao(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830028,China;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第二附属医院,乌鲁木齐830028 [2]新疆医科大学第一附属医院,乌鲁木齐830011

出　　处：《磁共振成像》2019年第12期881-884,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号：81860301)~~

摘　　要：目的应用高分辨率磁共振成像(high resolution magnetic resonance imaging,HR-MRI)技术分析颅内动脉粥样硬化狭窄患者的斑块特征与发生缺血性卒中事件的关系。材料与方法回顾性分析44例HR-MRI检查的颅内动脉粥样硬化狭窄患者的斑块情况,通过三维时间飞跃法磁共振血管成像(3D-time of flight magnetic resonance angiography,3D-TOF MRA)检查,按管腔狭窄程度将患者分为轻度狭窄组、中度狭窄组和重度狭窄组,根据斑块是否导致缺血性卒中及发生缺血性卒中距HR-MRI检查时间,将斑块分为急性/亚急性期责任斑块组、慢性期责任斑块组、非责任斑块组,比较3组的动脉粥样硬化危险因素(性别、年龄、吸烟史、饮酒史、高血压、糖尿病史、血糖、总胆固醇、高密度脂蛋白、低密度脂蛋白)以及斑块特征(管腔狭窄程度、斑块强化程度)。结果44例患者中急性/亚急性期责任斑块数目为29个,慢性期责任斑块数目为20个,非责任斑块数目为17个。急性/亚急性期责任斑块组、慢性期责任斑块组、非责任斑块组的管腔狭窄程度、斑块强化程度差异有统计学意义(P<0.05);而3组的动脉粥样硬化危险因素差异均无统计学意义。结论颅内动脉粥样硬化狭窄患者斑块强化程度和管腔狭窄程度与是否发生缺血性卒中具有相关性;明显强化的、导致管腔严重狭窄的斑块稳定性更差,更容易发生缺血性卒中。Objective:To investigate the relationship between plaque characteristics of patients with intracranial atherosclerotic stenosis and ischemic stroke.Materials and Methods:The plaques of 44 patients with intracranial atherosclerotic stenosis examined by high resolution magnetic resonance imaging(HR-MRI)were retrospectively analyzed.According to 3D-TOF MRA images to analyze the degree of stenosis,the patients were divided into mild stenosis group,moderate stenosis group and severe stenosis group according to the degree of stenosis.According to whether the plaques caused ischemic stroke and the time of ischemic stroke from HR-MRI examination,the plaques were divided into acute/subacute phase responsible plaque group,chronic phase responsible plaque group,and non-responsible plaque group.The risk factors of atherosclerosis and plaque characteristics(stenosis degree and plaque enhancement degree)were compared among the three group.Results:Among 44 patients,29 were responsible plaques in acute/subacute phase,20 were responsible plaques in chronic phase and 17 were non-responsible plaques.There were significant differences in the degree of lumen stenosis and plaque enhancement between the acute/subacute responsible plaque group,the chronic responsible plaque group and the non-responsible plaque group(P<0.05).However,there were no statistically significant risk factors for atherosclerosis in the three groups.Conclusions:The degree of plaque enhancement and the degree of stenosis in patients with intracranial atherosclerotic stenosis are correlated with the occurrence of ischemic stroke.The plaques that are obviously strengthened and severely stenosis of the lumen are less stable and more prone to occur ischemic stroke.

关 键 词：磁共振成像 卒中 动脉粥样硬化 斑块 狭窄 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]