颈动脉粥样硬化斑块与急性脑梗死体积的相关性研究

发布时间：2018-01-12 18:07

  本文关键词：颈动脉粥样硬化斑块与急性脑梗死体积的相关性研究　出处：《天津医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 急性脑梗死 颈动脉粥样硬化 斑块 磁共振成像 高分辨率

【摘要】：目的:应用3.0T多序列高分辨率MRI对颈动脉斑块进行分型、定量测量斑块负荷并分析其组成成分,探讨颈动脉斑块分型、负荷及组成成分与急性脑梗死的相关性。方法:选取65例颈内动脉供血区急性脑梗死患者,使用Philips Intera Achieva 3.0T MRI扫描仪,于发病7天内行头颅和双侧颈动脉MRI检查(头颅扫描序列包括T1WI、T2WI、FLAIR及DWI;颈动脉扫描序列包括T1WI、T2WI、MP-RAGE及3D-TOF)。在DWI序列上测量急性脑梗死体积;根据蔡剑鸣等制定的颈动脉斑块的MRI分型标准,采用CASCADE软件对斑块进行分型,并分析其组成成分;测量平均颈动脉管腔面积(LA)、平均血管总面积(TVA),计算出平均管壁面积(WA)、平均管壁标准化指数(NWI);测量颈动脉斑块内脂质核心体积。采用SPSS 20.0统计学软件,计量资料采用t检验,计数资料采用χ2检验,缺血侧斑块平均标准化指数及斑块内脂质核心体积与同侧急性脑梗死体积的关系采用Spearman秩相关分析,P0.05被认为有统计学意义。结果:(1)65例病例中,60例患者图像质量符合要求;(2)缺血侧颈动脉Ⅳ-Ⅴ型及Ⅵ型斑块的发生率、斑块内脂质核心的发生率、平均管壁面积(WA)以及平均管壁标准化指数(NWI)均高于非缺血侧,差异具有统计学意义(P0.05)(3)缺血侧颈动脉平均管壁标准化指数(NWI)及斑块内脂质核心体积与同侧急性脑梗死体积具有较强的正相关性(P0.05)。结论:颈动脉粥样硬化斑块与急性脑梗死的发生密切相关,3.0T MR能够清晰显示颈动脉斑块的组成成分,对颈动脉斑块进行分型、定量测量颈动脉管壁负荷以及斑块内部成分的体积,从而对预测脑缺血事件的发生、监控病情的发展提供帮助。
[Abstract]:Objective: the application of multiple 3.0T sequences of high resolution MRI of carotid artery plaque type, quantitative measurement and analysis of the components of plaque burden, to investigate the correlation of carotid artery plaque type, load and composition with acute cerebral infarction. Methods: 65 cases of internal carotid artery blood supply area of acute cerebral infarction patients, the use of Philips Intera Achieva 3.0T MRI the scanner, in 7 days of onset underwent head and bilateral carotid artery MRI examination (MRI scanning sequences included T1WI, T2WI, FLAIR and DWI; carotid artery scanning sequences included T1WI, T2WI, MP-RAGE and 3D-TOF). The measurement of the volume of acute cerebral infarction in the DWI sequence; according to the carotid plaque to Cai Jianming's MRI classification standard the plaques were classified according to CASCADE software, and analyzed its composition; measuring the mean carotid artery lumen area (LA), the average total vessel area (TVA), calculated the average wall area (WA), average wall standard Index (NWI); lipid core volume measurement of carotid artery plaque. Using SPSS 20 statistical software, measurement data using t test, count data using 2 test, ischemic side plaque lipid core volume average standard index and plaque and ipsilateral volume of acute cerebral infarction with Spearman rank correlation analysis, P0.05 is considered there was statistical significance. Results: (1) in 65 cases, 60 cases of patients with image quality to meet the requirements; (2) the incidence of ischemic carotid artery - IV V and VI type of plaque, the incidence rate of plaque lipid core, the average wall area (WA) and the average normalized wall index (NWI) were higher than those in non ischemic side, the difference was statistically significant (P0.05) (3) ischemic carotid artery average normalized wall index (NWI) and lipid core plaques in the same side with the volume of the volume of acute cerebral infarction has a strong positive correlation (P0.05). Conclusion: carotid artery congee Atherosclerosis plaque and acute cerebral infarction is closely related to the occurrence of 3.0T and MR can clearly show the composition of carotid plaque, carotid artery plaque type, measurement of carotid artery wall plaque volume quantitative load and internal components, in order to forecast the occurrence of cerebral ischemic events, help the development of monitoring condition.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.33
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本文编号：1415364