3.0T高分辨磁共振成像技术在急性缺血性脑卒中的应用及预后影响因素分析  

Application of 3.0T HR-MRI technique in AIS and an analysis on the influence factors of prognosis

作　　者：许海娜[1] 梁慧[2] 王振平[1] 冯志慧 赵应满[1] 钟健 秦鑫[1] Xu Haina;Liang Hui;Wang Zhenping;Feng Zhihui;Zhao Yingman;Zhong Jian;Qin Xin(Department of Radiology,Hainan General Hospital,Haikou 570311,China;Department of Neurology,Hainan General Hospital,Haikou 570311,China;Department of Cerebrovascular Diseases,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院放射科,海口570311 [2]海南省人民医院神经内科,海口570311 [3]海南省人民医院脑血管病科,海口570311

出　　处：《中国医学装备》2024年第1期63-68,共6页China Medical Equipment

基　　金：海南省卫生健康行业科研项目(22A200005)。

摘　　要：目的:探讨3.0T高分辨磁共振(HR-MRI)成像技术在急性缺血性脑卒中(AIS)的应用及预后影响因素。方法:选取2019年1月至2022年6月海南省人民医院收治的92例AIS患者,均予以溶栓治疗,并在治疗后90 d依据改良Rankin量表(mRS)将其纳入预后良好组(66例,mRS评分≤2分)与预后不良组(26例,m RS评分>2分)。所有患者于入院1周内行MagnetomTrio型3.0T HR-MRI检查,对比管腔狭窄率、最狭窄处管腔面积、斑块负荷、T_(2)加权成像(T_(2)WI)信号强度指数、T_(1)WI信号强度指数及斑块强化率参数变化;采用受试者工作特征(ROC)曲线,分析3.0THR-MRI参数对AIS预后的预测价值;采用二元Logistic回归模型分析影响AIS患者预后的危险因素。结果:两组患者梗死灶直径比较,差异具有统计学意义(x^(2)=6.574,P<0.05)。预后不良组患者最狭窄处管腔面积低于预后良好组,T_(2)WI信号强度指数、T_(1)WI信号强度指数及斑块强化率均高于预后良好组,两组比较差异有统计学意义(t=-3.378、4.443、4.413、3.890,P<0.05)。ROC曲线分析显示,T_(2)WI信号强度指数、T_(1)WI信号强度指数、最狭窄处管腔面积及斑块强化率预测AIS预后的ROC曲线下面积(AUC)值分别为0.743、0.739、0.706和0.748。Logistic回归分析显示,梗死灶直径>3.0 cm、T_(1)WI信号强度指数、T_(2)WI信号强度指数、最狭窄处管腔面积及斑块强化率是影响AIS预后的独立危险因素(OR=3.889、257.151、105.073、4.091、1.121,P<0.05)。结论:3.0THRMRI在AIS患者预后评估中具有较高效能,能通过观察T_(2)WI信号强度指数、T_(1)WI信号强度指数、最狭窄处管腔面积、斑块强化率等参数变化,为预后判断及治疗方案制定提供指导,且上述参数是影响患者预后的危险因素,往往代表患者病情进展。Objective:To investigate the application of 3.0T high resolution magnetic resonance imaging(HR-MRI)in acute ischemic stroke(AIS)and the influence factors of prognosis.Methods:A total of 92 AIS patients who underwent treatment in Hainan General Hospital from January 2019 to June 2022 were selected as the research objects.All patients were treated by thrombolytic therapy,and they were divided into favorable prognosis group(mRS scores≤2 points,n=66)and poor prognosis group(mRS score>2 points,n=26)according to modified Rankin Scale after they received 90d treatment.All of patients underwent Magnetom Trio type of 3.0 T HR-MRI examination within 1 week after they hospitalized,and the changes of luminal stenosis rate,the luminal area at the narrowest point,the plaque load,T_(2)WIsignal intensity index,T_(1)WI signal intensity index,plaque enhancement rate and other parameters were compared.The receiver operating characteristics(ROC)curve was adopted to analyze the predictive value of 3.0T HR-MRI parameters on the AIS prognosis.Binary Logistic regression model was used to analyze the risk factors that affected the prognosis of AIS patients.Results:The difference of infarction diameter between two groups was statistically significant(x^(2)=6.574,P<0.05).The lumen area at the narrowest point in the poor prognosis group was significantly lower than that in the favorable prognosis group,while the T_(2)WI signal intensity index,T_(1)WI signal intensity index and plaque enhancement rate in the poor prognosis group were significantly higher than those in the favorable prognosis group(t=-3.378,4.443,4.413,3.890,P<0.05),respectively.ROC curve analysis showed that the area under curve(AUC)values of T_(2)WI signal intensity index,T_(1)WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate in predicting the AIS prognosis were respectively 0.743,0.739,0.706 and 0.748.The Logistic regression analysis showed that infarction diameter>3.0cm,T_(1)WI signal intensity index,T_(2)WI signal intensity index,l

关 键 词：高分辨磁共振(HR-MRI)成像技术 急性缺血性脑卒中(AIS) 预后 影响因素 

分 类 号：R445.2[医药卫生—影像医学与核医学]