老年人LEPAD HRMR血管管壁成像研究

发布时间：2018-04-03 16:21

本文选题：老年人　切入点：LEPAD　出处：《扬州大学》2014年硕士论文

【摘要】：第一部分下肢血管HRMR管壁成像技术基础与方法本研究所用磁共振黑血血管管壁成像序列为3DMERGE,此序列血流抑制技术为iMSDE。股动脉磁共振扫描时数据分两段采集,在Philips后处理工作站将两次扫描的图像融合。图像分析时将股动脉分为三个节段：分叉段、收肌管段及远段。在MATLAB软件中半自动分析股动脉。半自动分析软件具有较好可重复性,同一测试者两次测量组内相关系数为0.972、95%的可信区间为0.941-0.986,p值0.001。第二部分HRMR管壁成像技术在老年人LEPAD中的应用研究目的：应用高分辨率MRI管壁成像技术研究老年人LEPAD病变的影像学特征。材料与方法：应用MR管壁成像序列3D-MERGE对44位无下肢动脉粥样硬化相关临床症状且年龄≥60岁受试者下肢动脉成像。将下肢动脉分为三个节段分析,分叉段、收肌管段及远段,分析斑块发生率及钙化发生率。应用后处理软件在2D横轴位重建图像上计算最大管壁厚度,斑块负荷最大位置计算管腔狭窄程度及斑块偏心指数。结果：本组44例老年人下肢粥样硬化斑块发生率为63.6%,其中,50.0%的斑块发生于分叉段,且该节段的斑块负荷明显大于其他血管节段。此外,最大管壁厚度与狭窄程度基本呈明显正相关(r=0.769,p0.001)；0%狭窄的受试者中,11.1%出现斑块。右侧下肢斑块负荷高于左侧,但差异无统计学意义。分叉段最大管壁厚度大于收肌管段及远段,差异有统计学意义(2.26±0.80mm vs.1.64±0.29mm, p0.001;2.26±0.80mm vs.1.88±0.69mm, p0.001)。结论：高分辨率MRI管壁成像技术可以提供老年人群LEPAD病变的相关影像信息,可以评估斑块负荷,为该疾病的诊断、治疗和预防提供重要依据。第三部分老年人LEPAD磁共振表现与临床、实验室指标的相关性研究目的：应用高分辨率MR管壁成像技术研究无症状老年人群下肢动脉粥样硬化病变特征与临床、实验室指标的相关性。材料与方法：收集44例受试者临床信息。应用MR管壁成像序列3DMERGE对44位无下肢动脉粥样硬化相关临床症状年龄大于或等于60岁受试者下肢动脉成像。将下肢动脉分为三个节段分析,分叉段、收肌管段及远段,分析斑块发生率及钙化发生率。应用后处理软件在2D横轴位重建图像上计算最大管壁厚度,斑块负荷最大位置计算管腔狭窄程度及斑块偏心指数。结果：本研究发现,性别与最大管壁厚度(p=0.002,r=0.464)、管腔狭窄程度(p=0.033,r=0.322)及偏心指数(p=0.006,r=0.407)有明显相关性；身高与最大管壁厚度有明显相关性(p=0.001,r=0.470)；体重与最大管壁厚度有明显相关性(p=0.045,r=0.304)；高血压与下肢动脉有无斑块有明显相关性(OR=4.64, p=0.023);70-80岁年龄组下肢粥样硬化斑块发生率大于60-69岁年龄组(71.9%vs.41.7%,p=0.064)；ABI值与最大管壁厚度之间没有明确相关性。结论：高血压与LEPAD关系密切,高血压是评价老年人下肢动脉粥样硬化斑块发生风险的有效指标；随着年龄增长,下肢粥样硬化病变发生率增加；单纯测量ABI会明显低估LEPAD的严重程度。
[Abstract]:The basis and method of HRMR tube wall imaging in the first part of the lower extremities
This study used magnetic resonance imaging of blood vessels sequence is 3DMERGE. This sequence flow suppression technique for iMSDE. femoral artery magnetic resonance scanning data acquisition workstation is divided into two sections, will be the two time scanning image fusion processing in Philips image analysis. The femoral artery was divided into three segments: bifurcation, close myotubes and distal. In the software of MATLAB semi automated analysis femoral artery. Semi automatic analysis software has good repeatability, the same test two times measure intraclass correlation coefficient was 0.972,95% confidence interval was 0.941-0.986, P value 0.001.
The application of the second part HRMR tube wall imaging technique in the LEPAD of the elderly
Objective: To study the imaging features of LEPAD lesions in the elderly with high resolution MRI tube wall imaging.
Materials and methods: MR imaging sequences of 44 3D-MERGE without lower extremity atherosclerosis related symptoms and 60 years of age or older subjects of lower limb angiography. Lower limb artery was divided into three segments analysis, bifurcation section, adductor canal and distal analysis, plaque incidence and calcium application. Postprocessing software maximum wall thickness calculation in 2D axial image reconstruction, maximum plaque load calculation the degree of luminal stenosis and plaque eccentricity index.
Results: 44 cases of elderly patients with lower limb atherosclerosis incidence was 63.6%, among them, 50% of the plaque at the bifurcation segment, and the segment of plaque burden was significantly higher than that of other vascular segments. In addition, there was a significant positive correlation with the degree of stenosis of the maximum wall thickness of the basic (r=0.769, p0.001); 0% stenosis subjects, 11.1% plaques. The right side of the lower extremity atherosclerotic plaque burden is higher than that of the left, but the difference was not statistically significant. The maximum wall thickness is greater than the bifurcation of adductor canal and distal, the difference was statistically significant (2.26 + 0.80mm vs.1.64 + 0.29mm, p0.001 + 0.80mm + 0.69mm 2.26; vs.1.88, p0.001).
Conclusion: high resolution MRI tube wall imaging can provide related imaging information of LEPAD lesions in elderly people, which can evaluate plaque load and provide important evidence for the diagnosis, treatment and prevention of this disease.
The correlation of LEPAD MRI performance with clinical and laboratory indicators in the third part of the elderly
Objective: To study the correlation between the characteristics of the atherosclerotic lesions of the lower extremities and the clinical and laboratory indexes of the asymptomatic elderly people with high resolution MR tube wall imaging.
Materials and methods: the clinical data of 44 cases of subjects. The application of MR imaging sequence 3DMERGE of 44 lower extremity atherosclerosis related clinical symptoms of age greater than or equal to 60 year old subjects of lower extremity artery imaging. Lower limb artery was divided into three segments analysis, bifurcation section, adductor canal and distal analysis. The incidence rate of plaque and calcification. Application of postprocessing software maximum wall thickness calculation in 2D axial image reconstruction, maximum plaque load calculation the degree of luminal stenosis and plaque eccentricity index.
Results: the study found that gender and the maximum wall thickness (p=0.002, r=0.464), the degree of stenosis (p=0.033, r=0.322) and eccentricity index (p=0.006, r=0.407) have significant correlation; height is significantly correlated with the maximum wall thickness (p=0.001, r=0.470); body weight has significant correlation with the maximum wall thickness (p=0.045, r=0.304); hypertension and arterial plaques have significant correlation (OR=4.64, p=0.023); 70-80 year old age group of lower extremity atherosclerotic plaque occurrence rate of more than 60-69 year old age group (71.9%vs.41.7%, p=0.064); there is no clear correlation between ABI value and the maximum thickness of the tube wall.
Conclusion: hypertension is closely related to LEPAD. Hypertension is an effective index to evaluate the risk of atherosclerotic plaques in the elderly. The incidence of atherosclerotic lesions of the lower extremities increases with age. Only measuring ABI can significantly underestimate the severity of LEPAD.

【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R543.5

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