高分辨MRI与超声造影在颈动脉粥样硬化斑块稳定性中的应用  

Application of High Resolution Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound in the Stability of Carotid Atherosclerotic Plaque

作　　者：董雪佳 刘雅虹 海俊杰 王智光[3] 张春雨[3] 江名芳[3] DONG Xuejia;LIU Yahong;HAI Junjie;WANG Zhiguang;ZHANG Chunyu;JIANG Mingfang(Department of Neurology,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010059,China;不详)

机构地区：[1]内蒙古赤峰市医院神经内科,内蒙古赤峰024000 [2]大同市第三人民医院神经内科,山西大同037000 [3]内蒙古医科大学附属医院神经内科,内蒙古呼和浩特010059

出　　处：《中国医学影像学杂志》2023年第8期803-807,共5页Chinese Journal of Medical Imaging

基　　金：内蒙古自治区自然科学基金(2020MS08197);内蒙古自治区卫健委2022年卫生健康科技计划(202201264)。

摘　　要：目的 比较高分辨磁共振成像(HRMRI)和超声造影(CEUS)在颈动脉粥样硬化斑块稳定性中的评估价值。资料与方法选取2019年11月—2020年11月于内蒙古医科大学附属医院经颈动脉彩色多普勒超声确诊存在颈动脉斑块患者71例,根据是否存在颈内动脉系统源性急性缺血性卒中(AIS),分为AIS组40例和非AIS组31例,分别行HRMRI和CEUS检查,统计两组斑块数量、类型、成分检出情况,比较两组颈动脉易损斑块的检出率,评价2种检查方法的一致性。结果 AIS组40例共106个斑块,非AIS组31例65个斑块,HRMRI检查中,AIS组易损斑块检出率为55.7%(59/106),非AIS组为36.9%(24/65),差异有统计学意义(χ^(2)=5.663,P=0.017)。CEUS检查中,AIS组易损斑块检出率为47.2%(50/106),非AIS组为30.8%(20/65),差异有统计学意义(χ^(2)=4.482,P=0.034);AIS组中,HRMRI对易损斑块的检出率高于CEUS(P=0.005),2种检查的一致性较差(Kappa=0.269)。结论 HRMRI和CEUS均能有效区分易损斑块,HRMRI对易损斑块的检出率更高,且能细化斑块成分,为临床诊断提供更多有价值的信息。Purpose To compare the evaluation value of high-resolution magnetic resonance(HRMRI) and contrast-enhanced ultrasound(CEUS) in the stability of carotid atherosclerotic plaque.Materials and Methods Seventy-one patients with carotid artery color plaques in the Affiliated Hospital of Inner Mongolia Medical University were selected from November 2019 to November 2020,and divided into acute ischemic stroke(AIS) group(n=40) and non AIS group(n=31) according to whether they had internal carotid artery derived AIS.HRMRI and CEUS examinations were performed on all patients.The data of number,type and composition of plaques were collected.The detection rates of vulnerable carotid plaques were compared between two examination methods,and the consistency of the two examination methods was also evaluated.Results There were 106 plaques in 40 patients with AIS and 65 plaques in 31 patients with non AIS.Among patients underwent HRMRI examination,the detection rate of vulnerable plaques in the AIS group was 55.7%(59/106),while the detection rate of vulnerable plaques in the non AIS group was 36.9%(24/65),with a statistically significant difference(χ^(2)=5.663,P=0.017).Among patients underwent CEUS examination,the detection rate of vulnerable plaques in the AIS group was 47.2%(50/106),while the detection rate of vulnerable plaques in the non AIS group was 30.8%(20/65),with a statistically significant difference(χ^(2)=4.482,P=0.034).In AIS group,the detection rate of vulnerable plaques in HRMRI was significantly higher than that in CEUS(P=0.005) with poor consistency of the two approaches(Kappa=0.269).Conclusion HRMRI and CEUS can effectively distinguish vulnerable plaques.HRMRI has a higher detection rate of vulnerable plaques,and can refine plaque components and provide more valuable information for clinical diagnosis.

关 键 词：急性缺血性卒中 磁共振成像 超声造影 斑块稳定性 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学] R445.1