摘要
目的 探究磁共振高分辨血管壁成像(HR-VWI)在脑卒中相关血管床斑块定量分析中的应用及与梗死灶体积、软脑膜侧支循环(LMC)关系。方法 回顾性分析2018年1月至2020年12月50例缺血性脑卒中患者临床资料,以50例短暂性脑缺血(TIA)患者为对照,患者均接受磁共振三维HR-VWI成像检查。对比2组MCA斑块定量指标,包括病变层面(MLN)和参考层面(RL)管腔面积(LA)、血管外壁面积(OWA)、病变层面管壁面积(WAMLN)、血管狭窄程度、斑块负荷、重构指数。分析大脑中动脉(MCA)狭窄率、斑块负荷、重构指数与梗死灶体积、易损斑块相关性。比较软脑膜侧支循环(LMC)不良组与良好组MCA斑块定量指标,绘制ROC曲线探究斑块定量指标预测LMC不良价值。结果 脑卒中组LAMLN明显小于TIA组(P<0.05),OWAMLN、WAMLN、斑块负荷、重构指数均明显大于TIA组(P<0.05)。脑卒中患者MCA狭窄率与梗死灶体积呈正相关(P<0.05),斑块负荷与梗死灶体积、易损斑块均呈正相关(P<0.05),重构指数与易损斑块呈正相关(P<0.05)。LMC不良组狭窄率、斑块负荷、重构指数明显高于LMC良好组(P<0.05)。MCA狭窄率、斑块负荷、重构指数及三者联合预测LMC不良的ROC曲线下面积分为0.755、0.862、0.676、0.919(P<0.05)。结论 脑卒中MCA狭窄斑块进行HR-VWI定量分析有助于患者病情、斑块易损性及软脑膜侧支循环状态评估。
Objective To explore the application of magnetic resonance high resolution vessel wall imaging(HRVWI) in the quantitative analysis of stroke-related vascular bed plaques and its relationship with infarct volume and leptomeningeal collateral circulation(LMC). Methods The clinical data of 50 patients with ischemic stroke from January 2018 to December 2020 were retrospectively analyzed, and 50 patients with transient ischemic attack(TIA) were used as controls. All patients underwent magnetic resonance three-dimensional HR-VWI imaging examination. The quantitative indicators of middle cerebral artery(MCA) plaques were compared between the two groups, including lumen area(LA) of maximal lumen narrowing(MLN) and referential lumen(RL), outer wall area(OWA), wall area of MLN(WAMLN), vascular stenosis degree, plaque burden and remodeling index. The correlation between MCA stenosis rate, plaque burden, remodeling index and infarct volume and vulnerable plaque was analyzed. The quantitative indicators of MCA plaques were compared between poor leptomeningeal collateral circulation(LMC) group and good LMC group, and ROC curves were drawn to explore the value of quantitative indicators of plaque in predicting the poor LMC. Results LAMLN in stroke group was significantly lower than that in TIA group(P<0.05), and the OWAMLN, WAMLN, plaque burden and remodeling index were significantly higher than those in TIA group(P<0.05). MCA stenosis rate in patients with stroke was positively correlated with infarct volume(P<0.05), and plaque load was positively correlated with infarct volume and vulnerable plaques(P<0.05), and remodeling index was positively correlated with vulnerable plaques(P<0.05). Stenosis rate, plaque burden and remodeling index in poor LMC group were significantly higher than those in good LMC group(P<0.05). The areas under ROC curves of MCA stenosis rate, plaque load, remodeling index and the combination of the three in predicting poor LMC were 0.755, 0.862, 0.676 and 0.919 respectively(P<0.05). Conclusion HRVWI quantitative analysis of MCA stenosis plaque in stroke is helpful to evaluate the disease condition, plaque vulnerability and status of leptomeningeal collateral circulation.
作者
郑艳龙
赵启利
刘博
张曦
苑春红
ZHENG Yan-long;ZHAO Qi-li;LIU Bo;ZHANG Xi;YUAN Chun-hong(Department of Diagnostic Radiology,The People’s Hospital of Langfang City,Langfang 065000,Hebei Province,China;Department of Obstetrics,The People’s Hospital of Langfang City,Langfang 065000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2023年第1期25-28,共4页
Chinese Journal of CT and MRI
基金
磁共振颅颈一体化高分辨血管壁成像对脑卒中相关血管床斑块负荷定量研究(182777176)。
关键词
缺血性脑卒中
磁共振
高分辨血管壁成像
狭窄率
斑块负荷
定量分析
Ischemic Stroke
Magnetic Resonance
High Resolution Vessel Wall Imaging
Stenosis Rate
Plaque Burden
Quantitative Analysis
