3D HRMRI-VWI技术在急性脑梗死患者病情程度与预后评估中的应用价值  

The Value of 3D HRMRI-VWI Technique in Assessing The Extent of Disease and Prognosis in Patients with Acute Cerebral Infarction

作　　者：郭小会 张洁[1] 刘立斌[2] Guo Xiao-hui;Zhang Jie;Liu Li-bin(Radiology Department of Daxing District People's Hospital,Beijing 102600,China;Neurology,Daxing District People's Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院放射科,北京102600 [2]北京市大兴区人民医院神经内科,北京102600

出　　处：《中国CT和MRI杂志》2023年第8期16-19,共4页Chinese Journal of CT and MRI

基　　金：北京市卫生科技发展专项基金(2019-2-929)。

摘　　要：目的探讨三维高分辨率磁共振血管壁成像(3D HRMRI-VWI)技术在急性脑梗死(ACI)患者病情程度诊断中的作用,并分析其在预后评估中的应用价值。方法选取我院2019年7月至2022年7月ACI患者116例,根据神经功能缺损(NIHSS)评分分为轻度组(37例)、中度组(48例)、重度组(31例),比较3组3D HRMRI-VWI技术定量参数,分析各参数与病情程度的相关性,随访30d,统计预后情况,对比不同预后患者治疗前后3D HRMRI-VWI技术定量参数,评价各参数对预后的评估价值。结果重度组最狭窄层面管腔面积<中度组<轻度组,狭窄率、斑块体积、斑块负荷、血管重构指数、最狭窄层面斑块强化率、斑块整体强化率>中度组>轻度组(P<0.05);最狭窄层面管腔面积与病情程度呈负相关(r=-0.512,P<0.05),狭窄率、斑块体积、斑块负荷、血管重构指数、最狭窄层面斑块强化率、斑块整体强化率与病情程度呈正相关(r=0.624、0.618、0.667、0.703、0.649、0.692,P<0.05);治疗30d后预后良好92例,预后不良24例;与预后良好患者相比,预后不良患者治疗前、治疗30 d后最狭窄层面管腔面积较小,狭窄率、斑块体积、斑块负荷、血管重构指数、最狭窄层面斑块强化率、斑块整体强化率较大(P<0.05);最狭窄层面管腔面积、狭窄率、斑块体积、斑块负荷、血管重构指数、最狭窄层面斑块强化率、斑块整体强化率单独评估预后不良的AUC为0.764(95%CI:0.676-0.838)、0.788(95%CI:0.703-0.859)、0.753(95%CI:0.664-0.828)、0.789(95%CI:0.703-0.859)、0.774(95%CI:0.687-0.846)、0.826(95%CI:0.744-0.890)、0.792(95%CI:0.707-0.862),联合评估预后不良的AUC为0.913(95%CI:0.847-0.958),大于各参数单独评估。结论最狭窄层面管腔面积、狭窄率、斑块体积、斑块负荷、血管重构指数、最狭窄层面斑块强化率、斑块整体强化率与病情程度密切相关,3D HRMRI-VWI可有效分析患者管腔狭窄情况、血管重构特点及斑块特Objective To investigate the role of three-dimensional high-resolution magnetic resonance vascular wall imaging(3D HRMRI-VWI)technology in the diagnosis of the extent of disease in patients with acute cerebral infarction(ACI)and to analyze its application value in prognostic assessment.Methods One hundred and sixteen patients with ACI From July 2019 to July 2022 in our hospital were selected and divided into mild group(37 patients),moderate group(48 patients)and severe group(31 patients)according to the neurological deficit(NIHSS)score,comparing the quantitative parameters of 3D HRMRIVWI technique in the three groups,analyzing the correlation between each parameter and the degree of disease,following up for 30d,counting the prognosis,comparing the quantitative parameters of 3D HRMRI-VWI technique before and after treatment in patients with different prognosis,and evaluating the value of each parameter in assessing the prognosis.Results The lumen area at the narrowest level in the severe group<moderate group<mild group,stenosis rate,plaque volume,plaque load,vascular remodeling index,plaque intensification rate at the narrowest level,and overall plaque intensification rate>moderate group>mild group(P<0.05).The lumen area at the stenosis level was negatively correlated with the extent of disease(r=-0.512,P<0.05),and the stenosis rate,plaque volume,plaque load,vascular remodeling index,plaque intensification rate at the stenosis level,and overall plaque intensification rate were positively correlated with the extent of disease(r=0.624,0.618,0.667,0.703,0.649,0.692,P<0.05).After 30 d of treatment,92 patients had a good prognosis and 24 patients had a poor prognosis;compared with patients with a good prognosis,patients with a poor prognosis had a smaller lumen area at the most stenotic level before and after 30 d of treatment,and a greater stenosis rate,plaque volume,plaque load,vascular remodeling index,plaque intensification rate at the most stenotic level,and overall plaque intensification rate(P<0.05).The AU Cs fo

关 键 词：神经功能缺损 急性脑梗死 三维高分辨率磁共振血管壁成像 相关性 

分 类 号：R739.45[医药卫生—肿瘤] R445.2[医药卫生—临床医学]