斑块内出血与基底动脉血管成形或支架置入术后新发栓塞性脑梗死的相关性  

Correlation between intraplaque hemorrhage and new-onset embolic cerebral infarction after basilar artery angioplasty or stenting

作　　者：马泽兰 刘波[1] 霍梦娟[1] 李国铭[2] 刘岘[1] 刘国清[1] 赵家欣 谢佳均 Ma Zelan;Liu Bo;Huo Mengjuan;Li Guoming;Liu Xian;Liu Guoqing;Zhao Jiaxin;Xie Jiajun(Department of Radiology,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Department of Neurology,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Department of Radiology,Guangzhou First People’s Hospital,Guangzhou 510013,China)

机构地区：[1]广东省中医院放射科,广州510120 [2]广东省中医院神经科,广州510120 [3]广州市第一人民医院放射科,510180

出　　处：《国际脑血管病杂志》2022年第10期725-731,共7页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金(81801688);广东省中医药管理局基金项目(20231141)。

摘　　要：目的探讨斑块内出血(intraplaque hemorrhage,IPH)与基底动脉血管成形或支架置入术后新发栓塞性脑梗死的相关性。方法回顾性连续纳入2015年1月至2022年2月期间因重度基底动脉粥样硬化性狭窄在广东省中医院神经科行基底动脉血管成形或支架置入术的患者。术前1周内行高分辨磁共振血管壁成像(high resolution magnetic resonance vessel wall imaging,HRMR-VWI)和弥散加权成像(diffusion-weighted imaging,DWI),术后72 h内行头颅DWI或CT检查确定新发栓塞性脑梗死患者。结果共32例患者纳入分析,10例患者基底动脉责任斑块存在IPH,5例患者术后新发栓塞性脑梗死。IPH组术后栓塞性脑梗死发生率显著高于非IPH组(50%对0%;P=0.001)。术后栓塞性脑梗死组IPH患者构成比显著高于非栓塞性脑梗死组(100%对18.5%;P=0.001)。结论IPH可能与基底动脉血管成形或支架置入术后新发栓塞性脑梗死事件相关。Objective To investigate the correlation between intraplaque hemorrhage(IPH)and new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.Methods Consecutive patients with severe basilar atherosclerotic stenosis underwent basilar artery angioplasty or stenting in the Department of Neurology,Guangdong Provincial Hospital of Chinese Medicine from January 2015 to February 2022 were retrospectively enrolled.High resolution magnetic resonance vessel wall imaging(HRMR-VWI)and diffusion-weighted imaging(DWI)were performed within one week before procedure,and brain DWI or CT examination was performed within 72 h after procedure to determine the patients with new-onset embolic cerebral infarction.Results A total of 32 patients were enrolled in the analyze.IPH existed in 10 patients with basilar artery culprit plaque,and 5 had new-onset embolic cerebral infarction after procedure.The incidence of embolic cerebral infarction in the IPH group was significantly higher than that in the non-IPH group(50%vs.0%;P=0.001).The proportion of patients with IPH in the embolic cerebral infarction group was significantly higher than that in the non-embolic cerebral infarction group(100%vs.18.5%;P=0.001).Conclusion IPH may be associated with new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.

关 键 词：磁共振成像 颅内动脉硬化 血管成形术 支架置入术 斑块内出血 

分 类 号：R651.12[医药卫生—外科学]