高分辨磁共振成像在缺血性脑卒中临床应用中的价值

发布时间：2018-03-25 08:07

本文选题：高分辨磁共振成像　切入点：大脑中动脉　出处：《中国老年学杂志》2017年15期

【摘要】：目的探讨缺血性脑卒中双侧大脑中动脉(MCA)粥样硬化管壁特点及动脉硬化脑卒中发生的危险因素。方法选取起病72 h确诊为MCA供血区梗死患者,行头部高分辨率磁共振成像(HRMRI)检查。分别测量及计算入组患者双侧MCA的最窄层面及参考层面的血管面积(VA)、管腔面积(LA)、管壁面积(WA)、斑块面积(PA)、斑块负荷、狭窄率、重塑指数等参数及评估斑块分布、斑块内出血等特征。结果比较入组患者卒中侧及卒中对侧MCA,最窄层面VA两者差异无统计学意义(P0.05);最窄层面LA卒中侧小于卒中对侧(P0.05);而最窄层面WA、斑块面积(PA)、斑块负荷及狭窄率卒中侧大于卒中对侧(P0.05)。两侧MAC重塑方式比例不同(χ~2=14.166,P0.05),且卒中正性重塑比例大于卒中对侧。MCA分布于下壁和腹侧壁斑块明显多于上壁或背侧壁;卒中侧分布于上壁和背侧壁斑块多于卒中对侧(χ~2=8.929,P0.05)。两侧MCA发生斑块内出血的比例不同(χ~2=10.637,P0.05),卒中侧要高于卒中对侧。结论动脉粥样硬化的斑块负荷、血管正性重塑、斑块分布及斑块内出血与缺血性脑卒密切相关。HRMRI能够更加准确评估动脉硬化血管状态,预测缺血性脑卒中发生风险。
[Abstract]:Objective to investigate the characteristics of atherosclerotic wall of bilateral middle cerebral artery (MCA) in ischemic stroke and the risk factors of atherosclerotic stroke. High resolution magnetic resonance imaging (HRMRI) of the head was performed to measure and calculate the vascular area of bilateral MCA, lumen area, lumen area, wall area, plaque area, plaque load and stenosis rate, respectively. Parameters such as remodeling index and evaluation of plaque distribution, Results compared with the stroke side and the stroke contralateral side MCA, there was no significant difference in the narrowest level VA between the two groups (P 0.05); the narrowest level LA stroke side was smaller than the stroke opposite side P 0.05%; and the narrowest level WAA, the plaque area was PAA. The load and stenosis rate of stroke side was larger than that of stroke contralateral side P0.05.The proportion of bilateral MAC remodeling was different (蠂 ~ 2 ~ 2 ~ (14. 166) ~ P ~ (0.05)), and the proportion of stroke positive remodeling was larger than that of stroke contralateral. MCA was more common in lower wall and ventral wall than in upper wall or dorsal wall. The number of plaques in the upper wall and dorsal wall of stroke was more than that in the opposite side of stroke (蠂 ~ 2 / 2 / 8.929 / P 0.05). The incidence of plaque hemorrhage in both sides of MCA was different (蠂 ~ (2 +) 10.637) P 0.05, and the stroke side was higher than that in the other side of stroke. Conclusion the plaque load of atherosclerosis and the positive remodeling of blood vessels are significant. Plaque distribution and intraplaque hemorrhage are closely related to ischemic stroke. HRMRI can more accurately evaluate arteriosclerotic vascular status and predict the risk of ischemic stroke.
【作者单位】：吉林大学中日联谊医院神经内一科;
【分类号】：R445.2;R743.3

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