颅内血管壁磁共振成像对大脑中动脉狭窄的病因分析  

Intracranial Vessel Wall Magnetic Resonance Imaging for Analysis of the Etiology of Middle Cerebral Artery Stenosis

作　　者：李文玲[1] 何洮梅 朱凯[1] 王爱军[1] 马丽[1] 朱力[1] LI Wenling;HE Taomei;ZHU Kai;WANG Aijun;MA Li;ZHU Li(Department of Radiology,General Hospital of Ningxia Medical University,the First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院放射科,宁夏医科大学第一临床医学院,银川750004 [2]宁夏医科大学,银川750004

出　　处：《宁夏医科大学学报》2025年第2期189-194,共6页Journal of Ningxia Medical University

基　　金：宁夏高等学校一流学科建设(宁夏医科大学国内一流建设学科临床医学)资助项目(NXYLXK2017A05)。

摘　　要：目的通过分析大脑中动脉(MCA)狭窄的磁共振成像(MRI)征象,鉴别MCA管腔狭窄病因,认识不同病变的影像学征象,评估识别颅内血管壁病理的潜力。方法收集2018年1月至2020年1月临床疑似缺血性脑卒中的住院病例,符合纳入标准的患者共65例,均行颅内血管壁磁共振成像(IVWI)检查。分析病变的影像特点并比较不同病变的影像学征象。结果65例患者中,动脉粥样硬化患者55例(84.62%)、动脉夹层3例(4.62%)、血管炎性病变5例(7.69%)、烟雾病2例(3.08%)。动脉粥样硬化患者中高危因素所占比例高于非动脉粥样硬化患者(χ^(2)=34.67,P=0.042)。2例动脉夹层表现为T1WI偏心性高信号,1例表现为血管腔呈螺旋状不规则狭窄,血管壁明显强化,管腔不同程度变窄,且变窄程度不规则。血管炎性病变表现为一侧MCA节段性不规则狭窄,明显强化。烟雾病1例累及右侧MCA中段,管腔闭塞,周围可见多发细小血管形成,另外1例累及右侧颈内动脉末端及MCA起始部,管腔明显变窄,管壁轻度强化,IVWI可见管腔向心性变窄,血管外径未见明显增宽。结论IVWI血管壁成像可以初步鉴别颅内血管病变,不同病变的影像学特征不同;颅内动脉狭窄最常见的病因为动脉粥样硬化。Objective To analyze the MRI features of middle cerebral artery(MCA)stenosis,identify the causes of MCA stenosis.Recognize the imaging features of different lesions,and assess the potential for identifying intracranial vascular wall pathology.Methods A total of 65 patients who were admitted for clinically suspected ischemic stroke from January 2018 to January 2020 and had IVWI scan.The image characteristics of the lesions were analyzed and classified,and the imaging signs of different lesions were compared.Results Among the 65 patients 55(84.62%)had atherosclerosis,3(4.62%)had artery dissection,5(7.69%)had vasculitis,2(3.08%)had moyamoya disease.The proportion of high-risk factors in patients with atherosclerosis was higher than that in patients without atherosclerosis(χ^(2)=34.67,P=0.042).Two cases showed eccentric high signal on T1WI,one showed spiral and irregular stenosis of vascular lumen,T1WI+C showed obvious enhancement of vascular wall,and the lumen narrowed in varying degrees,and the degree of narrowing was irregular.The vasculitis was characterized by irregular stenosis of MCA segment on one side and obvious enhancement of T1WI+C.One case of MMD involved the middle part of the right MCA,the lumen was occluded,and multiple small blood vessels were formed around it;the other case involved the end of the right internal carotid artery and the beginning of MCA,the lumen was obviously narrowed,the wall was slightly strengthened.IVWI showed that the lumen was centripetal narrowed,and the outer diameter of the blood vessels was not significantly widened.Conclusion IVWI can initially identify intracranial vascular lesions,and the imaging characteristics of different lesions are different;the most common lesion of intracranial artery stenosis is atherosclerosis.

关 键 词：血管壁磁共振成像 动脉粥样硬化 血管炎性病变 烟雾病 

分 类 号：R445.2[医药卫生—影像医学与核医学]