缺血性脑卒中患者高分辨率磁共振成像下后循环动脉粥样斑块特征与再发缺血事件的关系  

Relationship between Characteristics of Posterior Circulation Atherosclerotic Plaques and Recurrent Ischemic Events in Patients with Ishemic Stroke under High-Resolution Magnetic Resonance Imaging

作　　者：莫梦辉 王慧敏 周海燕 师利芬 董敏 程舒心 MO Menghui;WANG Huimin;ZHOU Haiyan;SHI Lifen;DONG Min;CHENG Shuxin(Department of Neurology,Xinxiang Central Hospital(The Fourth Clinical College of Xinxiang Medical College),Xinxiang 453000,China)

机构地区：[1]新乡市中心医院(新乡医学院第四临床学院)神经内科,河南省新乡市453000

出　　处：《中国医学计算机成像杂志》2024年第6期653-657,共5页Chinese Computed Medical Imaging

基　　金：河南省医药卫生科研项目(LHGJ20230877)。

摘　　要：目的:探讨缺血性脑卒中(IS)患者经高分辨率磁共振成像(HR-MRI)评估的后循环动脉粥样斑块特征与再发缺血事件的关系。方法:回顾性分析2021年3月—2023年3月在本院就诊的随访1年的IS患者,将再发缺血事件者纳入再发组(46例),未再发缺血事件者纳入未再发组(58例)。所有患者均通过HR-MRI检查分析后循环动脉粥样斑块特征,通过logistic回归分析斑块特征与患者再发缺血事件的关系。结果:再发组高血压病史比例高于未再发组,差异有统计学意义(P<0.05);再发组斑块形态学正性重构、斑块表面不规则比例高于未再发组,差异有统计学意义(P<0.05);再发组与未再发组间斑块范围弥漫、斑块内高信号、斑块偏心比例差异均无统计学意义(P>0.05);再发组与未再发组间血管总面积、参考血管总面积、参考管腔直径、管腔直径、管壁面积、管腔面积差异均无统计学意义(P>0.05);再发组斑块负荷指数、管腔狭窄率均大于未再发组,差异有统计学意义(P<0.05);再发组斑块强化程度大于未再发组,差异有统计学意义(P<0.05);Logistic回归分析结果显示高血压病史、后循环动脉粥样斑块正性重构、表面不规则、斑块强化以及斑块负荷指数增加、管腔狭窄率增大是IS患者再发缺血事件的独立危险因素。结论:HR-MRI下后循环动脉粥样斑块正性重构、表面不规则、斑块强化以及斑块负荷指数增加、管腔狭窄率增大可导致IS后再发缺血事件风险增加。Purpose:To explore the relationship between characteristics of posterior circulation atherosclerotic plaques and recurrent ischemic events in patients with ischemic stroke(IS)under high-resolution magnetic resonance imaging(HR-MRI).Methods:IS patients treated and followed up for 1 year in the hospital were retrospectively analyzed between March 2021 and March 2023,including 46 cases with ischemic events recurrence in recurrence group and 58 cases without recurrence in non-recurrence group.All patients underwent HR-MRI to analyze characteristics of posterior circulation atherosclerotic plaques.The relationship between plaque characteristics and recurrent ischemic events was analyzed by logistic regression analysis.Results:The proportion of hypertension history in recurrence group was higher than that in non-recurrence group(P<0.05),and proportions of plaque morphology(positive remodeling)and irregular plaque surface were also higher than those in non-recurrence group(P<0.05).There were no statistically significant differences in the proportions of diffused plaques,high signals in plaques and eccentric plaques between the two groups(P>0.05),and there were also no statistically significant differences in total areas of vessels or reference vessels,diameters of reference lumen or lumen,areas of tube wall or lumen between the two groups(P>0.05).The plaque load index and lumen stenosis rate in recurrence group were higher than those in non-recurrence group(P<0.05),and plaque enhancement degree was greater than that in nonrecurrence group(P<0.05).The results of logistic regression analysis showed that hypertension history,positive remodeling of posterior circulation atherosclerotic plaques,surface irregularity,plaque enhancement,increased plaque load index and lumen stenosis rate were independent risk factors of recurrent ischemic events in IS patients.Conclusion:Positive remodeling of posterior circulation atherosclerotic plaques,surface irregularity,plaque enhancement,increased plaque load index and lumen stenosis rat

关 键 词：缺血性脑卒中 后循环缺血 磁共振高分辨血管成像 动脉粥样斑块 缺血事件 

分 类 号：R445.2[医药卫生—影像医学与核医学]