基于HR-MRI分析MCAS患者血管管壁特征与卒中的关系  

Relationship between Vascular Wall Characteristics and Stroke in Patients with MCAS Based on HR-MRI Analysis

作　　者：王海波[1] 王振全[2] 段宏伟[1] 杨勇政[1] 丁琦峰[1] 孙英杰[1] 周山[1] WANG Hai-bo;WANG Zhen-quan;DUAN Hong-wei;YANG Yong-zheng;DING Qi-feng;SUN Ying-jie;ZHOU Shan(Department of Medical Imaging,the Second Affiliated Hospital of Luohe Medical College,Luohe 462300,Henan Province,China;Department of Anatomy,Luohe Medical College,Luohe 462002,Henan Province,China)

机构地区：[1]漯河医学高等专科学校第二附属医院医学影像科,河南漯河462300 [2]漯河医学高等专科学校解剖学教研室,河南漯河462002

出　　处：《中国CT和MRI杂志》2024年第5期64-66,共3页Chinese Journal of CT and MRI

基　　金：河南省医学教育研究项目(Wjlx2021181)。

摘　　要：目的基于三维高分辨率磁共振(HR-MRI)分析大脑中动脉粥样硬化性狭窄(MCAS)患者血管管壁特征与卒中的关系。方法回顾性分析2020年4月~2023年4月我院收治的100例MCAS患者临床资料,根据病变血管是否引发卒中情况,将其分为责任血管组(引发卒中的大脑中动脉,n=100)和非责任血管组(对侧未引发卒中的大脑中动脉,n=77),比较两组大脑中动脉斑块分布情况、斑块类型、斑块强化类型、斑块强化程度及管壁参数。结果100例MCAS患者中共发现227个斑块,其中责任血管组中有106个,非责任血管组中有121个;两组均以前壁斑块最为常见,但责任血管组上壁斑块所占比例(26.42%)明显高于非责任血管组(14.88%)(P<0.05)。责任血管组不规则斑块所占比例(63.21%)明显高于非责任血管组(43.80%)(P<0.05)。责任血管组偏心性强化斑块及高度强化斑块所占比例(84.91%、53.77%)明显高于非责任血管组(30.58%、8.26%),无强化和轻度强化斑块所占比例(7.55%、17.92%)明显低于非责任血管组(16.53%、43.80%),差异均有统计学意义(P<0.05)。责任血管组管腔狭窄程度、最大管壁厚度、管壁面积及斑块负荷均明显大于非责任血管组(P<0.05)。结论HR-MRI可清晰显示MCAS患者血管管壁特征,有助于评估斑块稳定性和识别责任血管,对预防卒中的发生具有一定参考价值。Objective To analyze the relationship between vascular wall characteristics and stroke in patients with middle cerebral artery syndrome(MCAS)based on three-dimensional high-resolution magnetic resonance imaging(HR-MRI).Methods The clinical data of 100 patients with MCAS admitted to our hospital from April 2020 to April 2023 were retrospectively analyzed,and the patients were divided into responsible vessel group(the middle cerebral artery that caused stroke,n=100)and the nonresponsible vessel group(the opposite middle cerebral artery that did not cause stroke,n=77)according to whether the diseased vessels caused stroke.The distribution of middle cerebral artery plaques,plaque type,plaque enhancement type,plaque enhancement degree and wall parameters were compared between the two groups.Results A total of 227 plaques were found in 100 patients with MCAS,including 106 plaques in responsible vessel group and 121 plaques in non-responsible vessel group.Anterior wall plaque was the most common in both groups,but the proportion of upper wall plaque in responsible vessel group(26.42%)was significantly higher than that in non-responsible vessel group(14.88%)(P<0.05).The proportion of irregular plaque in responsible vessel group(63.21%)was significantly higher than that in non-responsible vessel group(43.80%)(P<0.05).The proportions of eccentric enhanced plaque and highly enhanced plaque in responsible vessel group(84.91%,53.77%)were significantly higher compared with those in non-responsible vessel group(30.58%,8.26%)while the proportions of unenhanced and mildly enhanced plaques(7.55%,17.92%)were significantly lower than those in non-responsible vessel group(16.53%、43.80%)(P<0.05).The lumen stenosis degree,maximum wall thickness,wall area and plaque load were significantly higher in responsible vessel group than those in non-responsible vessel group(P<0.05).Conclusion HR-MRI can clearly display the characteristics of vascular wall in patients with MCAS,and it is helpful to evaluate the plaque stability and identify th

关 键 词：卒中 HR-MRI MCAS 管壁特征 最大管腔狭窄处 管壁参数 

分 类 号：R445.2[医药卫生—影像医学与核医学]