颈动脉MRI血管斑块特点对轻型急性前循环脑卒中及短暂性脑缺血发作早期预后的诊断价值  

The diagnostic value of carotid plaque features on magnetic resonance imaging for early outcome of mild acute anterior circulation ischemic stroke and transient ischemic attack

作　　者：魏博[1] 桂小红[1] 杜烨 徐轶钦 肖桂荣[1] 吴承龙[1] WEI Bo;GUI Xiaohong;DU Ye;XU Yiqin;XIAO Guirong;WU Chenglong(Authors'address:Department of Neurology,Shaoxing People's Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院神经内科,312000

出　　处：《心电与循环》2023年第4期341-344,348,I0001,共6页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科技计划项目(2019RC294)。

摘　　要：目的 探讨颈动脉MRI血管斑块特点对轻型急性前循环缺血性脑卒中(AACIS)及短暂性脑缺血发作(TIA)早期预后的诊断价值。方法 选择2018年6月至2020年6月绍兴市人民医院神经内科收治的轻型AACIS及TIA患者158例,根据发病后90d的预后分成进展组62例和非进展组96例,分析并比较两组患者MRI症状侧颈动脉斑块负荷、斑块成分以及动脉硬化斑块的MRI分型。结果 观察组症状侧颈动脉最大管壁标准化指数(64.85±7.10)%、平均管壁标准化指数(49.42±5.31)%、最大管壁面积(72.64±21.22)mm2、最大管壁厚度(3.91±0.92)mm、斑块内出血最大面积百分比(11.22±0.85)%、斑块纤维帽破裂比例(67.74%)以及Ⅵ型斑块比例(75.81%)均高于对照组[(54.60±5.35)%,(43.24±3.40)%,(51.37±18.03)mm2,(2.81±0.74)mm,(2.53±0.77)%,35.42%,54.17%],差异均有统计学意义(均P<0.01)。颈动脉最小管腔面积、脂质坏死核最大面积百分比及钙化最大面积百分比组间比较,差异均无统计学意义(均P>0.05)。结论MRI显示的血管斑块特性对轻型AACIS和TIA患者近期预后有重要价值。Objective To investigate the diagnostic value of carotid plaque features on magnetic resonance imaging(MRI)for early outcome of patients with mild acute anterior circulation ischemic stroke(AACIS)and transient ischemic attack(TIA).Methods A total of 158 inpatients with mild AACIS and TIA in Shaoxing People's Hospital from June 2018 to June 2020 were selected.They were divided into progressive group(62 cases)and non-progressive group(96 cases)based on outcome within 90 days.The plaque load of symptomatic carotid artery,the plaque composition and the plaque classification on MRI were analyzed and compared between the two groups.Results The maximum and average normalized wall index[(64.85±7.10)%,(49.42±5.31)%],the maximum wall area and maximum wall thickness[(72.64±21.22)mm2,(3.91±0.92)mm],the percentage of the largest area of intra-plaque hemorrhage(11.22±0.85)%,the percentage of plaque fibrous cap rupture(67.74%)and typeⅥplaque(75.81%)were significantly higher in progressive group than in non-progressive group[(54.60±5.35)%,(43.24±3.40)%,(51.37±18.03)mm2,(2.81±0.74)mm,(2.53±0.77)%,35.42%,54.17%](all P<0.01).The minimum lumen area,the percentage of the largest area of lipid-rich necrotic core and percentage of the largest area of calcification were not significantly difference between the two groups(all P>0.05).Conclusion Carotid plaque features on MRI are of important diagnostic value for early outcome of patients with mild AACIS and TIA.

关 键 词：轻型卒中 短暂性脑缺血发作 颈动脉 粥样硬化斑块 MRI 

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]