不同壁内血肿高分辨率MRI信号对椎-基底动脉夹层动脉瘤患者预后的影响  

The effect of different signals of intramural hematoma in HR-MRI on the prognosis of patients with vertebrobasilar artery dissecting aneurysmsy

作　　者：张学贤 谢璇丞 冯超凡 杨凯 赵卫[1] 李自恒 孟雪柔 ZHANG Xuexian;XIE Xuancheng;FENG Chaofan;YANG Kai;ZHAO Wei;LI Ziheng;MENG Xuerou(Department of Medical Imaging,First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《介入放射学杂志》2021年第12期1205-1209,共5页Journal of Interventional Radiology

摘　　要：目的评价不同的壁内血肿高分辨率MRI(HR-MRI)信号对椎-基底动脉夹层(VBAD)动脉瘤患者血管内治疗预后的影响,分析其预测预后的价值。方法回顾性分析2017年9月至2020年6月在昆明医科大学第一附属医院接受血管内治疗的21例VBAD动脉瘤患者临床资料。所有患者术前均接受HR-MRI检查,根据3D-快速自旋回波(FSE)-T1加权成像(WI)上壁内血肿不同信号对患者进行分组。采用改良Rankin量表(mRS)评分标准评价患者预后,计算各组患者好转率、稳定率和加重率,分析壁内血肿不同信号对预后的影响。结果21例患者血管内治疗均获成功。随访时间5~33个月,平均15.9个月,无失访。高信号组与等-低信号组好转率、加重率比较,差异均有统计学意义(P<0.05);等-高信号组与等-低信号组加重率比较,差异有统计学意义(P<0.05)。结论VBAD动脉瘤壁内血肿高信号组和等-高信号组患者预后较优于等-低信号组患者,术前壁内血肿不同信号可预测血管内治疗术后预后。Objective To evaluate the effect of different signals of intramural hematoma in high resolution MRI(HR-MRI)on the prognosis of patients with vertebrobasilar artery dissecting(VBAD)aneurysms after endovascular treatment,and to analyze its prognostic value.Methods The clinical data of 21 patients with VBAD aneurysm,who were admitted to the First Affiliated Hospital of Kunming Medical University of China between September 2017 and June 2020 to receive endovascular therapy,were retrospectively analyzed.Preoperative HR-MRI was performed in all patients.According to the different signals of intramural hematoma displayed on 3D-FSE-T1WI,the patients were divided into different groups.Modified Rankin Scale(m RS)score was used to evaluate patient’s prognosis,and the improvement rate,stability rate and aggravation rate of each group were calculated.The influence of different signals of intramural hematoma on the prognosis was analyzed.Results Successful endovascular treatment was accomplished in all the 21 patients.The patients were followed up for 5-33 months,with a mean of 15.9 months.No patient was lost in touch.The differences in the improvement rate and aggravation rate between high signal group and iso-low signal group were statistically significant(P<0.05).Statistically significant difference in the aggravation rate existed between iso-high signal group and iso-low signal group(P<0.05).Conclusion In patients with VBAD aneurysm,the prognosis in high signal group and iso-high signal group is better than that in iso-low signal group.The preoperative signal intensity of intramural hematoma displayed on HR-MRI can predict the prognosis of patients after receiving endovascular therapy.

关 键 词：高分辨率磁共振成像 壁内血肿 椎-基底动脉夹层动脉瘤 血管内治疗 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]