颈动脉中至重度狭窄患者斑块特征与脑白质高信号相关性研究  

Correlation between carotid plaque characteristics and white matter hyperintensity in patients with moderate to severe carotid stenosis

作　　者：刘颖[1] 霍然 徐慧敏[1] 王筝[1] 王涛[2] 袁慧书[1] LIU Ying;HUO Ran;XU Huimin;WANG Zheng;WANG Tao;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,China;Department of Neurosurgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191 [2]北京大学第三医院神经外科,北京100191

出　　处：《实用放射学杂志》2023年第9期1387-1390,共4页Journal of Practical Radiology

摘　　要：目的 采用颈动脉 MR管壁成像分析颈动脉中至重度狭窄患者斑块特征及其与脑白质高信号(WMH)的相关性.方法 采用 MR管壁成像测量 105 例患者的颈动脉狭窄程度、最大管壁厚度(Max WT)、标准化管壁指数(NWI),计算斑块内出血(IPH)、脂质坏死核(LRNC)、钙化和溃疡的体积及最大面积百分比.采用视觉评定量表 Fazekas 进行脑白质评分.比较斑块有无上述成分时 WMH 严重度差别;比较不同 WMH 严重程度时管腔狭窄程度、Max WT和 NWI差别;比较不同 WMH 严重程度及评分时斑块成分体积及最大面积百分比差别.结果 (1)斑块内有无上述成分时,严重和轻度 WMH 差异无统计学意义.(2)严重和轻度 WMH 时,颈动脉狭窄程度、Max WT和 NWI差异无统计学意义.(3)不同侧脑室 WMH 评分时,IPH 体积差异有统计学意义(F=3.047,P=0.032).结论 在单侧颈动脉中至重度狭窄患者中,尽管斑块负荷及成分特征不足以判断 WMH 严重程度,但IPH 体积与侧脑室旁 WMH 评分相关,提示 IPH 可能是侧脑室 WMH 评分的有效预测指标.Objective To explore the relationship between carotid plaque characteristics and white matter hyperintensity(WMH)in patients with moderate to severe carotid stenosis by carotid MR vessel wall imaging.Methods The degree of carotid stenosis,maximum wall thickness(Max WT)and normalized wall index(NWI)of 105 patients were measured by MR vessel wall imaging.The volume and maximum area percentage of the intraplaque hemorrhage(IPH),lipid-rich necrotic nucleus(LRNC),calcification and ulcer were calculated.The visual rating scale Fazekas was used to evaluate the brain white matter.The severity of WMH was compared between plaque with and without the above components.The degree of carotid stenosis,Max WT and NWI were compared in different WMH severity.The differences of plaque volume and maximum area percentage were compared in different WMH severity and WMH scores.Results(1)There were no significant differences between severe and mild WMH with and without above plaque components.(2)There were no significant differences in the degree of carotid stenosis,Max WT and NWI between severe and mild WMH patients.(3)There was significant difference in IPH volume among different lateral ventricle WMH scores(F=3.047,P=0.032).Conclusion In patients with moderate to severe stenosis of unilateral carotid artery,the plaque load and component characteristics are not enough to assess the severity of WMH.The volume of IPH is related to the paraventricular WMH score,suggesting that IPH may be effective predictor for lateral ventricle WMH scores.

关 键 词：颈动脉斑块 血管壁成像 脑白质高信号 脑白质评分 

分 类 号：R543.4[医药卫生—心血管疾病] R742[医药卫生—内科学]