MRI斑块分级系统的构建及其对颈动脉支架植入术后新发弥散加权成像病灶预测效能的评估  

Construction of MRI plaque grading system and evaluation of its effectiveness in predicting new lesions on diffusion weighted imaging after carotid artery stenting

作　　者：赵格非 孙伟[3] 唐涵斐 薛松 梁静[4] ZHAO Gefei;SUN Wei;TANG Hanfei;XUE Song;LIANG Jing(Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, P.R.China;Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R.China;Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R.China;Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, P.R.China)

机构地区：[1]南京大学医学院附属鼓楼医院心胸外科,江苏南京210008 [2]复旦大学附属中山医院血管外科,上海200032 [3]复旦大学附属中山医院影像科,上海200032 [4]南京大学医学院附属鼓楼医院影像科,江苏南京210008

出　　处：《医学影像学杂志》2021年第8期1278-1282,共5页Journal of Medical Imaging

摘　　要：目的建立基于多对比MRI的颈动脉斑块分级系统并评价其对颈动脉支架植入术(carotid artery stenting,CAS)后颅内新发弥散加权成像(diffusion-weighted image,DWI)病灶的预测效能。方法基于高分辨多对比MRI图像的斑块分级系统构建CAS术后颅内新发DWI病灶预测模型并进行评价。结果亚急性期斑块内出血(intraplaque hemorrhage,IPH)、II级IPH、II级脂质坏死核心、主动脉弓部溃疡和支架类型是CAS后新发DWI病灶的独立危险因素。结论CAS后颅内新发DWI病灶是由多因素导致的,斑块分级系统的引入将更有助于颈动脉狭窄患者的个体化治疗。Objective To establish a carotid plaque grading system based on multi contrast magnetic resonance imaging(MRI)and to evaluate its predictive value for new lesions on diffusion weighted imaging(DWI)after carotid artery stenting(CAS).Methods According to the constructed plaque grading system based on high-resolution multi-contrast MR images,the prediction model of new intracranial DWI lesions after CAS was constructed and evaluated.Results Subacute intraplaque hemorrhage(IPH),IPH in grade II,LRNC in grade II,aortic arch ulcer and stent type were independent risk factors for new ipsilateral lesions on DWI after CAS.Conclusion The new ipsilateral lesions on DWI after CAS are caused by multiple factors.The introduction of IPH staging and plaque grading system will be more helpful for the individualized treatment of patients with carotid stenosis.

关 键 词：斑块 分级系统 颈动脉支架植入术 磁共振成像 

分 类 号：R543.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]