摘要
目的探究脑白质疏松及颅内责任血管斑块与深部穿支动脉供血区梗死程度的相关性。方法回顾性纳入行常规颅脑MRI、MR血管成像(MRA)及高分辨血管壁成像(HR-VWI)的穿支动脉供血区急性梗死的病人44例,包括男35例,女9例,平均年龄(64.16±9.87)岁。根据梗死灶径线大小将病人分为非腔隙性梗死组(NLI组,16例)和腔隙性梗死组(LI组,28例)。在HR-VWI影像的垂直于血管长轴的层面上进行斑块测量和计算,包括斑块处及邻近正常参照血管的血管外壁面积(OWA)、管腔面积(LA)、斑块处管壁面积(WA)、血管狭窄率、斑块重构率(RR)、管壁面积指数以及斑块负荷。采用t检验或χ2检验比较NLI组和LI组间的临床资料、脑白质疏松程度及是否具有颅内责任血管斑块的差异,对差异有统计学意义的风险因素进行多因素Logistic回归分析。并采用t检验、Mann-Whitney U检验或χ2检验进一步比较2组间颅内责任血管斑块特点的差异。结果NLI组中的中重度脑白质疏松病人的比例[62.50%(10/16例)]高于LI组[28.57%(8/28例)],P<0.05;有责任斑块的病人比例[68.75%(11/16例)]高于LI组[32.14%(9/28例)],P<0.05。多因素Logistic回归分析显示,中重度脑白质疏松和具有责任斑块的病人发生非腔隙性梗死的风险更高,优势比(OR)值分别为5.747(95%CI:1.275~25.900)及6.300(95%CI:1.392~28.514),AUC分别为0.670(95%CI:0.499~0.840)和0.683(95%CI:0.516~0.850)。2组间斑块测量参数比较,NLI组LA小于LI组,而WA、血管狭窄率、管壁面积指数、正性重构例数及斑块负荷均大于LI组(均P<0.05)。结论深部穿支动脉供血区梗死的严重程度与病人脑白质疏松程度及是否具有责任斑块相关;伴有中重度脑白质疏松或具有责任血管斑块时,穿支动脉供血区出现的梗死灶都相对更大。
Objective To explore the correlation of leukoaraiosis and intracranial responsible vessel plaque with deep penetrating infarction.Methods We retrospectively studied 44 patients with acute deep penetrating infarction,who had undergone conventional MRI,MRA,and high-resolution vessel wall imaging(HR-VWI)examination,including 35males and 9 females,with an average age of 64.16±9.87 years.The patients were divided into non-lacunar infarction group(NLI,16 patients)and lacunar infarction group(LI,28 patients)according to the size of infarct.We measured and calculated the plaques at the level perpendicular to the long axis of the vessel on HR-VWI images,including the outer wall area(OWA)of the vessel at the plaque and adjacent normal reference vessels,lumen area(LA),wall area(WA),stenosis rate,remodeling ratio(RR),wall area index,and plaque burden.The t test or Chi-square test was used to compare the differences in clinical data,the degree of leukoaraiosis and the presence of intracranial responsible vascular plaques between the NLI and LI groups,and multivariate Logistic regression analysis was performed for risk factors with statistically significant differences.And differences in intracranial responsible vessel plaque characteristics between the 2 groups were further compared using ttest,Mann-Whitney U test or Chi-square test.Results The NLI group(62.50%,10/16)had more severe leukoaraiosis than the LI group(28.57%,8/28),P<0.05;and the NLI group had more responsible plaques(68.75%,11/16)than the LI group(32.14%,9/28),P<0.05.Multivariate logistic regression analysis showed the patients with severe leukoaraiosis or responsible plaques had higher rate of NLI.The odds ratios were 5.747(95%CI:1.275-25.900)and 6.300(95%CI:1.392-28.514),respectively.The AUC were 0.670(95%CI:0.499-0.840)and 0.683(95%CI:0.516-0.850),respectively.The LA of the NLI group was small,and the WA,stenosis rate,wall area index,numbers of positive remolding and plaque burden were larger than that of the LI group(all P<0.05).Conclusions The degree of deep penetrating infarction is correlated with degree of leukoaraiosis and presence of responsible plaque.When presence of moderate to severe leukoaraiosis or responsible vascular plaque,the deep perforating infarction lesions is relatively large.
作者
范然
卜玮艺
包翠萍
杨筠
李一鸣
刘筠
FAN Ran;BU Weiyi;BAO Cuiping;YANG Jun;LI Yiming;LIU Jun(Department of Radiology,Tianjin Union Medical Center,Tianjin 300121,China;Department of Medical Imaging,The Second Affiliated Hospital of Xi’an Jiaotong University;Tianjin Fourth Central Hospital;The Institute of Translational Medicine,Tianjin Union Medical Center of Nankai University)
出处
《国际医学放射学杂志》
北大核心
2022年第4期390-395,共6页
International Journal of Medical Radiology
