HR-MR VWI在椎基底动脉延长扩张症管壁重构中评估作用及对脑梗死预测价值研究  

The role of HR-MR VWI in evaluating the remodeling of VBD vessel wall and its predictive value for cerebral infarction

作　　者：肖瑶 康志雷 耿姿慧 王心颖 管铁岗 刘兵 XIAO Yao;KANG Zhi-lei;GENG Zi-hui;WANG Xin-ying;GUAN Tie-gang;LIU Bing(Imaging Center,Hengshui People's Hospital,Hebei Province,Hengshui 053000,China;Imaging Center,the Fourth People's Hospital of Hengshui City,Hebei Province,Hengshui 053000,China;Department of Neurology,Hengshui People's Hospital,Hebei Province,Hengshui 053000,China)

机构地区：[1]河北省衡水市人民医院影像中心,河北衡水053000 [2]河北省衡水市第四人民医院影像中心,河北衡水053000 [3]河北省衡水市人民医院神经内科,河北衡水053000

出　　处：《河北医科大学学报》2023年第9期1080-1086,1092,共8页Journal of Hebei Medical University

基　　金：河北省医学科学研究课题计划(20220470)。

摘　　要：目的探讨MR高分辨血管壁成像(high resolution magnetic resonance vascular wall imaging,HR-MR VWI)在椎基底动脉延长扩张症(vertebrobasilar artery lengthening and dilation,VBD)管壁重构中评估作用及对脑梗死预测价值。方法选取VBD患者200例,均行HR-MR VWI检查。根据6个月内是否发生脑梗死分为发生组、未发生组,比较2组管壁重构情况、管壁特点、斑块特点,Pearson分析管壁重构指数与最窄层面管腔狭窄率、斑块负荷关系,分析VBD发生脑梗死的相关影响因素及HR-MR VWI各参数预测VBD发生脑梗死的价值。结果发生组与未发生组管壁重构情况比较差异有统计学意义(P<0.05);发生组最窄层面血管面积、管壁面积高于未发生组,最窄层面管腔狭窄率、斑块负荷高于未发生组,不稳定斑块多于未发生组(P<0.05);管壁重构指数与最窄层面管腔狭窄率、斑块负荷呈正相关(P<0.05);正性重构、最窄层面血管面积和管壁面积、最窄层面管腔狭窄率、不稳定斑块、斑块负荷均与VBD患者发生脑梗死独立相关(P<0.05);正性重构、最窄层面血管面积和管壁面积、最窄层面管腔狭窄率、不稳定斑块、斑块负荷联合预测脑梗死的AUC大于单一预测的AUC。结论HR-MR VWI检查对于VBD管壁重构、管壁特点及斑块具有较高评估价值,各指标联合检测可用于临床对并发脑梗死的预测中,为临床制定干预方案提供参考。Objective To investigate the role of high-resolution MR magnetic resonance vessel wall imaging(HR-MR VWI)in evaluating the remodeling of vertebrobasilar dolichoectasia(VBD)and its predictive value for cerebral infarction.Methods A total of 200 VBD patients were selected and underwent HR-MR VWI examination.The patients were divided into the occurrence group(n=44)and the non-occurrence group(n=156)according to occurrence of cerebral infarction within 6 months.The vessel wall remodeling,vessel wall characteristics,and plaque characteristics were compared between two groups.Pearson analysis was used to analyze the relationship between vessel wall remodeling index and the narrowest luminal stenosis rate and plaque load.The relevant influencing factors of cerebral infarction in VBD patients and the value of HR-MR VWI parameters in predicting the occurrence of cerebral infarction in VBD were analyzed.Results There was a significant difference between the occurrence group and the non-occurrence group with respect to the vessel wall remodeling(P<0.05).Vessel area and wall area at the narrowest slice,the narrowest luminal stenosis rate and plaque load were higher than those in the non-occurrence group,and the number of unstable plaque was more than that in the non-occurrence group(P<0.05).The wall remodeling index was positively correlated with the narrowest luminal stenosis rate and plaque load(P<0.05).Positive remodeling,vessel area and wall area at the narrowest slice,the narrowest luminal stenosis rate,unstable plaque,and plaque load were independently associated with cerebral infarction in patients with VBD(P<0.05).The area under ther receiver operating characteristic(ROC)curve(AUC)of the combination of positive remodeling,vessel area and vessel wall area at the narrowest slice,the narrowest luminal stenosis rate,unstable plaque,and plaque load in predicting cerebral infarction was greater than that predicted by a single indicator detection.Conclusion HR-MR VWI examination has high evaluation value for vessel wall rem

关 键 词：椎底动脉供血不足 高分辨血管壁成像 管壁重构 

分 类 号：R735.7[医药卫生—肿瘤]