大脑中动脉粥样硬化斑块特征与缺血性卒中患者长期复发风险的相关性分析  

Correlation between the characteristics of atherosclerotic plaques in the middle cerebral artery and the risk of long-term recurrence in patients with ischemic stroke

作　　者：陈坤健 王新怡[1] 毛慧敏 郭宇 王心雨 张超 CHEN Kun-jian;WANG Xin-yi;MAO Hui-min;GUO Yu;WANG Xin-yu;ZHANG Chao(Department of Radiology,the First Affiliated Hospital of Shandong First Medical University&Shangdong Provincial Qianfoshan Hospital,Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)放射科,山东济南250014

出　　处：《中国临床医学影像杂志》2022年第2期91-95,100,共6页Journal of China Clinic Medical Imaging

基　　金：山东省科技发展计划项目合同书(编号2009GG10002024)。

摘　　要：目的:利用高分辨率血管壁磁共振成像(VW-MRI)技术识别缺血性卒中患者责任斑块的基本影像学特征,进一步探讨卒中患者斑块特征与缺血性事件长期复发风险的相关性。方法:选取68例经临床证实的单侧大脑中动脉(MCA)狭窄患者,均在3.0T磁共振上行常规MRI及VW-MRI扫描。收集患者基本临床资料,根据临床常用的评估缺血性卒中患者长期复发风险的工具SPI-Ⅱ评分标准将入组患者分为低危风险组、中危风险组、高危风险组,对比分析三组患者导致MCA狭窄责任斑块的基本影像学特征(斑块的偏心指数、面积、长度、强化幅度);进一步评估斑块特征参数与卒中长期复发风险评分之间的相关性。结果:中危风险组和高危风险组责任斑块的偏心指数、面积、长度、强化幅度均高于低危风险组,差异有统计学意义(P<0.05),而中危风险组和高危风险组之间差异无明显统计学意义(P>0.05),斑块基本特征与卒中长期复发风险评分之间存在中等程度正相关(r=0.43,r=0.55,r=0.42,r=0.41,P<0.05)。结论:MCA粥样硬化斑块的影像学特征与卒中患者长期复发风险存在一定的相关性,可以为临床风险评估提供一定的帮助。Objective:To identify the basic imaging features of responsible plaques in patients with ischemic stroke by high resolution vessel wall magnetic resonance imaging(VW-MRI),and to further explore the correlation between plaque features and the risk of ischemic events long-term recurrence.Methods:Sixty-eight patients with clinically proven unilateral middle cerebral artery(MCA)stenosis were selected.Conventional MRI and VW-MRI were performed on 3.0 T MRI.The basic clinical data of the patients were collected.According to the SPI-Ⅱscoring standard,a commonly used tool for evaluating the long-term recurrence risk of ischemic stroke patients,68 patients were divided into low-risk group,medium-risk group and high-risk group.The basic imaging characteristics(plaque eccentricity index,plaque area,plaque length,enhancement degree)of the responsible plaques in the three groups were compared and analyzed.The correlation between these plaque characteristics and the risk score of long-term stroke recurrence was evaluated.Results:The eccentricity index,area,length,enhancement degree of responsible plaque in medium-risk group and high-risk group were higher than those in low-risk group(P<0.05),but there was no significant difference between medium-risk group and high-risk group(P>0.05).There was a moderately positive correlation between the basic plaque characteristics and the risk score of long-term stroke recurrence(r=0.43,r=0.55,r=0.42,r=0.41,P<0.05).Conclusion:The imaging characteristics of responsible plaque were correlated with the risk of long-term recurrence in stroke patients,which can provide some help for clinical risk assessment.

关 键 词：大脑中动脉 斑块 动脉粥样硬化 卒中 磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]