颅内动脉粥样硬化斑块成分及特征与缺血性脑卒中相关性的HRMR-VWI研究  

HRMR-VWI study on the relationship between the components and characteristics of intracranial atherosclerotic plaque and ischemic stroke

作　　者：刘英 马利军[1] 王宝军[2] 刘晓林[1] 柴圣婷 苏宁[1] Liu Ying;Ma Lijun;Wang Baojun;Liu Xiaolin;Chai Shengting;Su Ning(Department of Imaging,Baotou Central Hospital,Baotou 014000,China;Department of Neurology,Baotou Central Hospital,Baotou 014000,China)

机构地区：[1]包头市中心医院影像科,内蒙古包头014000 [2]包头市中心医院神经内科,内蒙古包头014000

出　　处：《中华脑血管病杂志（电子版）》2023年第6期549-556,共8页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：包头市科技计划项目(wsjkkj067)。

摘　　要：目的应用高分辨磁共振血管壁成像技术(HRMR-VWI)分析颅内动脉粥样硬化(ICAS)斑块成分及特征与缺血性脑卒中的相关性。方法对2020年12月至2021年9月期间包头市中心医院神经内科的78例ICAS性狭窄的患者行HRMR-VWI扫描。将检出的颅内斑块分为责任斑块(67个)与非责任斑块(125个),比较2组间斑块成分、特征的差异。根据有无脑梗死病史将入组患者分为急性/亚急性脑梗死组(34例)、慢性脑梗死组(18例)、无脑梗死组(26例)3组,比较3组间责任斑块成分、特征的差异。运用SPSS 21.0软件进行统计分析,通过多元Logistic回归分析斑块成分、特征与缺血性脑卒中的关系,并通过Spearman相关分析其与美国国立卫生研究院卒中量表评分(NIHSS)的相关性,显著性检验水准α=0.05。结果责任斑块组斑块内出血(IPH)率(P<0.001)、血栓率(P<0.001)、明显强化率(P=0.010)、中重度血管狭窄程度(P<0.001)和斑块负荷(P<0.001)均显著高于非责任斑块组,差异均有统计学意义。急性/亚急性脑梗死组中责任斑块的IPH率(P=0.013)、血栓率(P=0.001)、斑块负荷(P<0.001)均显著高于无脑梗死组,差异均有统计学意义。IPH(rs=0.348、P=0.004)、血栓(rs=0.373、P=0.002)、斑块负荷(rs=0.360、P=0.003)与NIHSS评分均呈正相关关系。结论IPH、血栓的存在与责任斑块及同侧卒中事件密切相关。较大的斑块负荷可增加缺血性卒中事件发生的风险,且卒中的严重程度会更重、预后更差。Objective To analyze the correlation between the components and characteristics of intracranial atherosclerotic plaques and ischemic stroke by high-resolution MRI vascular wall imaging(HRMR-VWI).Methods 78 patients with intracranial atherosclerotic stenosis in the Department of Neurology of Baotou Central Hospital from December 2020 to September 2021 were scanned by HRMR-VWI.The detected intracranial plaques were divided into responsible plaques(67)and non-responsible plaques(125),and the differences in plaque composition and characteristics between the two groups were compared.According to the history of cerebral infarction,the patients were divided into three groups:acute/subacute cerebral infarction group(34 cases),chronic cerebral infarction group(18 cases),and non-cerebral infarction group(26 cases).The differences in the composition and characteristics of responsible plaque among the three groups were compared.Statistical analysis was conducted using SPSS 21.0 software,and the relationship between plaque composition,characteristics,and ischemic stroke was analyzed through multiple Logistic regression.The correlation with the National Institutes of Health stroke scale(NIHSS)was analyzed through Spearman correlation,and the significance test criteria were usedα=0.05.Results In the responsible plaque group,the rate of intraplaque hemorrhage(IPH)(P<0.001),the rate of thrombus(P<0.001),the rate of significant enhancement(P=0.010),the rate of moderate to severe stenosis(P<0.001),and the plaque load(P<0.001)were significantly higher than those in the non-responsible plaque group,and the differences were statistically significant.The rate of IPH(P=0.013),the rate of thrombus(P=0.001),and the plaque load(P<0.001)of responsible plaques in the acute/subacute cerebral infarction group were significantly higher than those in the non-cerebral infarction group,and the differences were statistically significant.IPH(rs=0.348,P=0.004),thrombus(rs=0.373,P=0.002),and plaque load(rs=0.360,P=0.003)were all positively correlated

关 键 词：高分辨磁共振血管壁成像 颅内动脉粥样硬化 斑块内出血 斑块负荷 

分 类 号：R743.1[医药卫生—神经病学与精神病学]