高分辨磁共振成像评估动脉粥样硬化性颅内动脉狭窄患者的斑块强化特征及其与脑卒中的关系研究  

Study on the HR-MRI in assessing plaque enhancement of patients with ICAS and relationship of that and stroke

作　　者：胡满意 王跃 李慧东 叶自青 Hu Manyi;Wang Yue;Li Huidong;Ye Ziqing(Department of Image,Beijing Huairou Hospital,Beijing 101400,China)

机构地区：[1]北京怀柔医院影像科,北京101400

出　　处：《中国医学装备》2024年第1期69-72,81,共5页China Medical Equipment

基　　金：北京市科技计划(Z201100008420002)。

摘　　要：目的:运用三维高分辨率磁共振成像(3D-HR-MRI)评估动脉粥样硬化性颅内动脉狭窄(ICAS)患者的责任斑块强化特征并探究其与脑卒中的关联性。方法:回顾性选取北京怀柔医院2019年4月至2022年4月收治的72例ICAS患者为研究对象,共有96个动脉粥样硬化性狭窄斑块。根据全脑数字减影血管造影结果将斑块分成轻-中度狭窄组(33个)和重度狭窄组(63个)。根据斑块发生时间(1个月内)划分为亚急性-急性斑块组(47个)和非急性斑块组(包括慢性斑块和无责任斑块)(49个)。由两位放射科医生对3D-HR-MRI的结果进行影像学特征评估,斑块强化程度以垂体强化程度为参照,根据斑块强度程度分成显著强化组(52个)和非显著强化组(包括中等强化组和非强化组)(44个)。分析ICAS、斑块强化程度和脑卒中的关联性。结果:72例患者中共检出96个动脉粥样硬化性狭窄斑块。多样本Kruskal-WallisH检验表明,脑卒中发生时间和斑块强化程度显著相关(H=3.294,P<0.05)。单因素Logistic回归分析表明急性斑块组和非急性斑块组间差异与ICAS程度[P<0.05,OR(95%CI)=1.0(0.3~2.6)]和斑块强化程度[P<0.05,OR(95%CI)=1.0(0.4~2.0)]均显著相关。多因素Logistic回归分析证实重度动脉狭窄[P<0.05,OR(95%CI)=1.0(0.3~1.9)]和斑块显著强化[P<0.05,OR(95%CI)=1.0(0.4~2.1)]均是脑卒中的独立危险因素。结论:严重的ICAS和斑块显著强化是脑卒中的独立危险因素,为临床脑卒中的预防、诊断和治疗提供了有效依据。Objective:To assess the enhancement characteristics of responsibility plaque of patients with intracranial artery stenosis(ICAS)and explore the correlation between that and stroke by using three dimensional highresolution magnetic resonance imaging(3D-HR-MRI).Methods:A total of 72 ICAS patients who admitted to Beijing Huairou Hospital from April 2019 to April 2022 were retrospectively selected as the study objects,with a total of 96 atherosclerotic stenosis plaques.The plaques were divided into mild to moderate stenosis group(33 cases)and severe stenosis group(63 cases)according to the results of whole brain digital subtraction angiography.They were also were divided into sub-acute/acute plaque group(within 1 month)(47 cases)and non-acute plaque group(including chronic and non-responsible plaques)(49 cases)according to the time of occurring plaque.The imaging characteristics of the 3D-HR-MRI results were assessed by two radiologists.The degrees of plaque enhancement referred to the degrees of pituitary enhancement,and the degrees of plaque enhancement were divided into significant enhancement group(52 cases)and non-significant enhancement group that included moderate enhancement group and non-enhancement group(44 cases).The relationships between ICAS,degree of plaque enhancement and stroke were analyzed.Results:A total of 96 atherosclerotic stenosis plaques were confirmed in 72 patients.The statistical analysis of Kruskal-Wallis H test of multiple samples showed that there was a significant correlation between the time of occurring plaque and the degree of plaque enhancement(H=3.294,P<0.05).Univariate Logistic regression analysis indicated that the difference between the acute plaque group and the non-acute plaque group was respectively significant correlations with ICAS degree[P<0.05,OR(95%CI)=1.0(0.3-2.6)]and degree of plaque enhancement[P<0.05,OR(95%CI)=1.0(0.4-2.0)].The multivariate Logistic regression analysis demonstrated that both severe arterial stenosis[P<0.05,OR(95%CI)=1.0(0.3-1.9)]and significant enhan

关 键 词：动脉粥样硬化 颅内动脉狭窄(ICAS) 高分辨磁共振成像(HR-MRI) 斑块强化 脑卒中 

分 类 号：R445.2[医药卫生—影像医学与核医学]