椎动脉优势与基底动脉形态及斑块特征间的关系:基于磁共振高分辨率血管壁成像  

Relationship between vertebral artery dominance and basilar artery morphology and plaque characteristics:based on high-resolution vessel wall imaging

作　　者：陈文静 沈龙山 CHEN Wenjing;SHEN Longshan(Department of Radiology,Shanghai First People's Hospital Bengbu Hospital(The Second Affiliated Hospital of Bengbu Medical College),Bengbu Medical College,Bengbu 233040,China;School of Medical Imaging,Bengbu Medical College,Bengbu 233030,China;Key Laboratory of Digital Medicine and Intelligent Health of Anhui General Colleges and Universities(Bengbu Medical College),Institute of Clinical Applied Anatomy,Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]上海市第一人民医院蚌埠医院(蚌埠医科大学第二附属医院)放射科,安徽蚌埠233040 [2]蚌埠医科大学医学影像学院,安徽蚌埠233030 [3]数字医学与智慧健康安徽普通高校重点实验室(蚌埠医科大学),蚌埠医科大学临床应用解剖研究所,安徽蚌埠233004

出　　处：《分子影像学杂志》2024年第10期1054-1060,共7页Journal of Molecular Imaging

基　　金：安徽省重点实验室开放课题(AHCM2023W001);数字医学与智慧健康安徽普通高校重点实验室(蚌埠医学院)一般项目(AHCM2022W001)。

摘　　要：目的通过磁共振高分辨率血管壁成像(HR-VWI)研究椎动脉优势(VAD)与非VAD患者基底动脉的形态、斑块分布及强化方式的差异。方法回顾性分析2022年6月~2024年3月蚌埠医科大学第附属二医院行磁共振HR-MRI检查的100例患者的临床资料及基底动脉形态、斑块特征。采用三维时间飞跃法磁共振血管造影正位视图,将患者分为VAD组(n=77)和非VAD组(n=23);测量椎动脉直径及基底动脉的直径、长度、弯曲方向和弯曲程度等参数。利用HR-VWI图像分析斑块的分布及强化程度,计算狭窄程度、重构指数及斑块负荷。结果两组患者一般资料的差异无统计学意义(P>0.05)。两组间基底动脉的弯曲方向、弯曲程度及斑块的分布和强化程度差异均有统计学意义(P<0.05)。VAD组基底动脉多向右侧弯曲。VAD组基底动脉的弯曲程度1级和3级占比较大,而非VAD组则主要集中在0级。VAD组斑块横向分布多位于腹侧壁(P=0.010),纵向分布多为远端斑块(P=0.047)。VAD组中斑块2级强化的比例显著高于非VAD组(P<0.05)。结论HR-VWI作为一项无创性核磁共振技术,可以清晰地显示椎-基底动脉的几何状态、血管壁及动脉粥样硬化斑块,定性或定量评估斑块特征和血管的重构状况、狭窄率等;椎动脉优势显著影响基底动脉的弯曲方向、弯曲程度及斑块的分布和强化程度。Objective To investigate differences in basilar artery morphology,plaque distribution,and enhancement patterns between vertebral artery dominance(VAD)and non-VAD patients using high-resolution vessel wall imaging(HR-VWI).Methods A retrospective analysis was conducted on clinical data and basilar artery morphology and plaque characteristics in 100 patients who underwent HR-MRI at the Second Affiliated Hospital of Bengbu Medical College from June 2022 to March 2024.Utilizing 3D time-of-flight magnetic resonance angiography,VAD group(n=77)and non-VAD group(n=23)were examined.Measurements included vertebral and basilar artery diameters,lengths,curvature direction,and degree.Plaque distribution and enhancement were analyzed using HR-VWI,calculating stenosis degree,remodeling index,and plaque burden.Results Clinical data showed no significant differences between the two groups(P>0.05).Significant differences were found in basilar artery curvature direction,degree,plaque distribution,and enhancement(P<0.05).In the VAD group,basilar artery curvature was predominantly rightward,with higher proportions of grade 1 and 3 curvature,while the non-VAD group mainly had grade 0 curvature.Plaque was more often distributed on the ventral wall(P=0.010)and distally(P=0.047)in the VAD group.Grade 2 plaque enhancement was significantly higher in the VAD group compared to the non-VAD group(P<0.05).Conclusion In VAD patients,the basilar artery predominantly curves to the right,with a higher proportion of moderate to severe curvature compared to non-VAD patients.Plaques in the basilar artery are more frequently located on the ventral wall and distally,with a more pronounced enhancement degree in VAD patients.Vertebral artery dominance significantly influences the direction and degree of basilar artery curvature,as well as plaque distribution and enhancement.

关 键 词：椎动脉优势 基底动脉 磁共振高分辨率血管壁成像 斑块 

分 类 号：R445.2[医药卫生—影像医学与核医学]