摘要
目的探讨高分辨率磁共振血管壁成像(high resolution magnetic resonance vessel wall imaging,HRMR-VWI)对椎-基底动脉系粥样硬化血管重构模式、斑块负荷、分布特点与急性脑梗死的关系.材料与方法入组后循环急性脑梗死患者32例,行磁共振常规序列检查(含扩散加权成像序列)和HRMR-VWI检查,证实存在后循环供血区脑梗死并测量责任血管管壁,计算责任血管的重构指数(remodeling index,RI=最狭窄处血管面积/参考处血管面积).比较正性和负性重构血管的斑块面积、负荷,观察责任斑块位置、分布及强化特点.结果 HRMR-VWI发现后椎-基底动脉粥样硬化斑块患者30例,其中基底动脉粥样硬化斑块18例,椎动脉(颅内段)粥样硬化斑块12例,2例脑桥旁梗死者未见明显斑块.责任血管正性重构21例,负性重构7例,无重构2例.正性重构组的斑块面积[(6.32±3.19)mm2]及斑块负荷[(0.51±0.13)%]均大于负性重构组的斑块面积[(2.14±1.43)mm2]及负荷[(0.28±0.19)%].椎-基底动脉粥样硬化斑块多发生于穿支动脉分支开口周围,以背外侧多见.椎-基底动脉系粥样硬化责任斑块多呈轻度或明显强化.结论 HRMR-VWI能够作为后循环急性脑梗死病因诊断的重要检查方法.
Objective: To investigate the relationship between vertebral-basal artery atherosclerotic vascular remodeling pattern, plaque burden, distribution characteristics and cerebral infarction by high resolution magnetic resonance vessel wall imaging (HRMR-VWI). Materials and Methods: Thirty-two patients with post-circulation acute cerebral infarction were enrolled, and routine magnetic resonance imaging (including DWI sequence) and HRMRVWI were performed to confirm the presence of cerebral infarction in the posterior circulation blood supply area and to measure the vessel wall of the responsible vessel and calculate the remodeling index (RI) of the vessel area at the narrowest point/vascular area at the reference. Compare the area of negative and positive remolding vascular plaque area, plaque burden, and observe the location distribution and enhancement characteristics of responsible plaque. Results: HRMR-VWI found 30 patients with vertebral-basal atherosclerotic plaque, including 18 cases of basilar atherosclerotic plaque, 12 cases of vertebral artery (intracranial part) atherosclerotic plaque, and 2 cases of parabrachial infarction without obvious plaques. Responsible vascular remodeling was performed in 21 patients, negative remodeling in 7 patients, and no remodeling in 2 patients. The plaque area (6.32±3.19) mm2 and plaque load (0.51±0.13)% of the positive remodeling group were larger than the plaque area of the negative remodeling group (2.14± 1.43) mm2 and the load (0.28±0.19)%. Vertebral-basal atherosclerotic plaques often occur around the opening of the branch of the perforating artery and are more common in the dorsolateral side. Conclusions: HRMR-VWI can be used as an important examination method for the diagnosis of post-circulation acute cerebral infarction.
作者
石增强
贾琳
贾文霄
韩秉艳
王云玲
SHI Zengqiang;JIA Lin;JIA Wenxiao;HAN Bingyan;WANG Yunling(Imaging Center,Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Imaging Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《磁共振成像》
CAS
2019年第10期743-747,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
新疆维吾尔自治区区域协同创新专项(科技援疆计划)(编号：2018E02063)~~
关键词
椎-基底动脉系统
斑块
动脉粥样硬化
高分辨磁共振血管壁成像
卒中
磁共振成像
vertebral-basal artery system
atherosclerotic plaque
high resolution magnetic resonance vascular wall imaging
stroke
magnetic resonance imaging
