后循环脑缺血的基底动脉高分辨磁共振成像研究  

The reasearch of basilar artery based on high-resolution magnetic resonance imaging in patients with posterior circulation ischemic attack

作　　者：周莹雪 崔英哲[1] 南东[1] 陈艳菲 刘鹏飞[1] ZHOU Yingxue;CUI Yingzhe;NAN Dong;CHEN Yanfei;LIU Pengfei(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,哈尔滨150001

出　　处：《磁共振成像》2021年第2期15-18,23,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,HR-MRI)探究短暂性脑缺血发作(transient ischemic attack,TIA)频发组与非频发组间基底动脉管壁差异。材料与方法将经过头部三维时间飞跃法磁共振血管造影(three-dimension time of flight magnetic resonance angiography,3D-TOF-MRA)和基底动脉HR-MRI扫描后发现斑块的患者纳入研究。根据24 h内TIA频次分为频发组(≥2次)和非频发组(<2次)。对两组斑块形态学指标、狭窄程度、血管重构、斑块分布及临床特点进行分析。结果68例TIA患者,共184个斑块(频发组:38例、108个,非频发组:30例、76个)。最狭窄层面的斑块形态学指标组间差异均有统计学意义(P均<0.05)。频发组狭窄程度、重构指数较非频发组高,差异均有统计学意义(P均<0.05)。频发组腹侧斑块占比较大(38.0%vs 22.4%),背侧斑块占比较小(17.6%vs 35.5%),差异均有统计学意义(P=0.025、0.006);两组侧壁斑块比例(44.4%vs 42.1%)相似,差异无统计学意义(P=0.753)。两组临床因素差异均无统计学意义(P均>0.05)。结论频发组斑块多分布于腹侧,非频发组多分布于背侧,两组侧壁斑块比例相似。频发组斑块负荷、狭窄程度、重构指数更高,非频发组斑块更稳定。Objective:The differences of basilar artery vessel wall between frequent patients and non-frequent patients with transient ischemic attack(TIA)were analyzed using high-resolution magnetic resonance imaging(HR-MRI).Materials and Methods:The patients were scanned by three-dimension time of flight magnetic resonance angiography(3D-TOF-MRA)of the head and HR-MRI of basilar artery,and the patients with plaques were enrolled in the study.According to the frequency of TIA within 24 hours,the patients were divided into the frequent group(≥2)and the non-frequent group(<2).The plaque morphological indexes,degree of stenosis,remodeling index,plaque distribution and clinical characteristics between the two groups were analyzed.Results:Sixty-eight patients with TIA(38 cases in the frequent group and 30 cases in the non-frequent group)had a total of 184 plaques(108 in the frequent group and 76 in the non-frequent group).At the maximal-lumen-narrowing site,the plaque morphological indexes in the frequent group were significantly different from those in the non-frequent group(P<0.05).The degree of stenosis and remodeling index in the frequent group were higher than those in the non-frequent group,and the differences were statistically significant(P<0.05).The plaques located at ventral wall of the frequent group(38.0%)accounted for a higher proportion as compared with the non-frequent group(22.4%)(P=0.025),and the plaques located at dorsal wall of the frequent group(17.6%)accounted for a lower proportion as compared with the non-frequent group(35.5%)(P=0.006).The proportion of lateral wall plaques in the frequent group(44.4%)was similar to that in the non-frequent group(42.1%),with no statistically significant difference(P=0.753).The clinical characteristics had no statistically significant differences between the two groups(P>0.05).Conclusions:Most of the plaques are distributed on the ventral side in the frequent group and on the dorsal side in the non-frequent group,and the proportion of lateral plaques are similar between t

关 键 词：高分辨 磁共振成像 斑块 动脉粥样硬化 短暂性脑缺血发作 

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]