多对比动脉粥样硬化特征序列诊断轻中度狭窄颈动脉斑块的初步研究  

Preliminary study on the diagnosis of carotid plaque with mild to moderate stenosis by multi-contrast atherosclerosis characterization sequence

作　　者：陈彦伊 申云霞[2] 娄明武[2] 梁冰[2] 陈蕾[2] 李勇 CHEN Yanyi;SHEN Yunxia;LOU Mingwu;LIANG Bing;CHEN Lei;LI Yong(Shenzhen College of Clinical Medicine,Guangzhou University of Chinese Medicine,Shenzhen,Guangdong Province 518116,China;Department of Radiology,Longgang District Centred Hospital of Shenzhen,Shenzhen,Guangdong Province 518116,China)

机构地区：[1]广州中医药大学深圳临床医学院,广东深圳518116 [2]深圳市龙岗中心医院医学影像科,广东深圳518116

出　　处：《实用放射学杂志》2020年第9期1402-1406,共5页Journal of Practical Radiology

基　　金：广东省科技厅基金项目(2017A020215190);龙岗区科创局基金项目(20160607145932628,20160606163814950)。

摘　　要：目的探讨多对比动脉粥样硬化特征(MATCH)序列对轻中度狭窄颈动脉斑块负荷、成分及易损性的诊断价值.方法选择轻中度狭窄颈动脉斑块患者64例,行常规序列[T1WI、T2WI、质子密度加权成像(PDWI)、三维时间飞跃(3D-TOF)、T1加权对比增强(T1WI+C)]及MATCH序列扫描.扫描范围以颈动脉分叉为中心上下3 cm.用VesselMass软件进行后处理和测量,对比MATCH序列与常规序列检测的斑块负荷指标[斑块体积(PV)、最大管壁厚度(MWT)、管壁面积(WA)、管腔面积(LA)、标准化管壁指数(NWI)]、斑块成分[斑块内出血(IPH)、钙化(CA)、坏死脂质核心(LRNC)]及斑块易损性.结果MATCH序列与常规T1WI+C序列检测的斑块负荷指标无明显差异:PV,131.06(116.88,167.03,244.71)mm^3 vs 127.94(106.39,167.27,260.63)mm^3(P>0.05);MWT,(4.42±1.61)mm vs(4.50±1.62)mm(P>0.05);WA,(69.67±18.05)mm^2 vs(67.80±18.53)mm^2(P>0.05);LA,133.78(29.01,38.24,50.02)mm^2 vs 125.22(28.78,37.85,44.50)mm^2(P<0.05);NWI,(63.22±9.72)%vs(64.71±8.39)%(P>0.05).MATCH序列与常规序列检测斑块成分及易损性结果一致,其中IPH、CA具有很好的一致性(Kappa=1,P<0.001;K ap pa=0.97,P<0.001),LRNC、斑块易损性具有较好的一致性(Kappa=0.705,P<0.001;Kappa=0.714,P<0.001).结论MATCH序列与常规序列诊断轻中度狭窄颈动脉斑块负荷、成分及易损性结果一致,MATCH序列具有扫描时间短、诊断简便的优势,是一种高效的临床影像学诊断方法.Objective To explore the value of multi-contrast atherosclerosis characterization(MATCH)sequence on the diagnosis of the loading,composition and vulnerability of carotid plaque with mild to moderate stenosis.Methods Sixty—four patients with mild to moderate stenosis of carotid plaque were recruited for conventional sequence(T1WI,T2WI,PDWI,3D-TOF,T1WI+C)and MATCH sequence scanning.The scanning area was 3 cm above and below the bifurcation of carotid artery.VesselMass software was used for imaging post-processing and measurement.The plaque load indexes(PV,MWT,WA,LA,NWI),plaque composition(IPH,CA,LRNC)and plaque vulnerability evaluated by MATCH sequence and conventional sequence were compared.Results There was no significant difference in the plaque load indexes between the MATCH sequence and the conventional T1WI+C sequence:PV,131.06(116.88,167.03,244.71)mm^3 vs 127.94(106.39,167.27,260.63)mm^3(P>0.05);MWT,(4.42±1.61)mm vs(4.50±1.62)mm(P>0.05);WA,(69.67±18.05)mm^2 vs(67.80±18.53)mm^2(P>0.05);LA,133.78(29.01,38.24,50.02)mm^2 vs 125.22(28.78,37.85,44.50)mm^2(P<0.05);NWI,(63.22±9.72)%vs(64.71±8.39)%(P〉0.05).The plaque composition and vulnerability detected by the MATCH sequence were consistent with those detected by conventional sequence,and moreover,IPH and CA had excellent consistency(Kappa=1,P<0.001;Kappa=0.97,P<0.001),LRNC and plaque vulnerability had satisfactory consistency(Kappa=0.705,P<0.001;Kappa=0.714,P<0.001).Conclusion MATCH sequence is consistent with the conventional sequence for diagnosing the loading,composition and vulnerability of carotid plaque with mild to moderate stenosis,and has the advantages in short scan time and simple diagnosis,which is an efficient clinical imaging diagnosis method.

关 键 词：多对比动脉粥样硬化特征序列 颈动脉斑块 斑块负荷 斑块成分 斑块易损性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]