无症状性基底动脉粥样硬化的的斑块分布和动脉重塑

发布时间：2018-04-09 06:11

本文选题：基底动脉粥样硬化　切入点：动脉重塑　出处：《吉林大学》2017年硕士论文

【摘要】：目的:无症状性基底动脉粥样硬化的斑块分布和动脉重塑特点尚不明确,本研究旨在采用三维高分辨磁共振成像探索无症状性基底动脉粥样硬化的斑块分布特征及重塑规律。方法:回顾性分析来自北京协和医院HR-MRI数据库(2014年8月至2016年12月)的无症状性基底动脉粥样硬化患者,采用3D CUBE T1WI分析患者的斑块和管壁特征,包括斑块分布、油条征、斑块成分,并测量斑块部位及参考部位的管周面积、管腔面积、最大管壁厚度和基底动脉直径。结果:研究共纳入无症状性基底动脉粥样硬化患者46例和对照组55例。1)无症状性基底动脉粥样硬化患者的斑块负荷最大象限主要是侧壁(66.7%),斑块横向分布以多象限受累为主(91.8%),纵向分布上以小脑前下动脉开口处的远端多见(71.4%)。2)缩窄性重塑是无症状性基底动脉粥样硬化斑块的主要形式,占55.1%。仅1例患者的基底动脉可见缩窄性重塑斑块和扩张性重塑斑块共存。与扩张性重塑组相比,缩窄性重塑组的狭窄率更大(p0.01),油条征出现率更低(p=0.045),重塑指数、管周面积、管腔面积、管壁面积和基底动脉直径更小(p0.01;p0.01;p=0.021;p0.01;p=0.001)。3)与对照组相比,无症状性基底动脉病变组(参考部位)的管周面积、管腔面积及基底动脉直径均无显著性差异(p=0.416;p=0.083;p=0.252),油条征出现率更低(p=0.041)。结论:无症状性基底动脉粥样硬化斑块负荷最大象限主要是侧壁,纵向分布以小脑前下动脉开口处的远端多见。无症状性基底动脉粥样硬化存在以缩窄性重塑为主的局灶性重塑,但不存在普遍性重塑。采用三维高分辨磁共振成像分析基底动脉斑块分布和动脉重塑的特征有助于揭示颅内动脉粥样硬化的发展过程和评估缺血性卒中的风险。
[Abstract]:Objective: arterial remodeling and plaque distribution characteristics of asymptomatic basilar atherosclerosis is not clear, the purpose of this study is to use three-dimensional high resolution magnetic resonance imaging of asymptomatic atherosclerotic plaque distribution and substrate remodeling law. Methods: a retrospective analysis of Peking Union Medical College Hospital from the HR-MRI database (August 2014 to December 2016) the non symptomatic basilar atherosclerosis patients CUBE T1WI, by 3D analysis of patients with plaque and wall characteristics, including the distribution of patches, Deep-Fried Dough Sticks syndrome, plaque, and plaque measuring and reference of the peritubular area, lumen area, maximum wall thickness and diameter of the basilar artery. Results: the study included 46 cases and control group of 55 patients with.1 symptoms basal atherosclerotic plaque burden) maximum quadrant in asymptomatic patients with atherosclerosis is the main substrate side wall (66.7%), plaque cross To the distribution with multi quadrant involvement (91.8%), longitudinal distribution in the anterior inferior cerebellar artery opening of the distal common (71.4%).2) constrictive remodeling is the main form of plaques of basal symptoms, accounted for only 55.1%. of 1 patients with basilar artery constrictive remodeling and visible plaque remodeling expansion compared with the expansion of plaques coexist. Remodeling group, stenosis rate of constrictive remodeling group more (P0.01), Deep-Fried Dough Sticks syndrome (p=0.045), the occurrence rate of lower remodeling index, peritubular area, lumen area, wall area and smaller diameter of basilar artery (P0.01; P0.01; p=0.021; P0.01; p=0.001).3) compared with the control group, no symptomatic basilar artery lesion group (reference site) of the peritubular area, there were no significant differences between the lumen area and the diameter of basilar artery (p=0.416; p=0.083; p=0.252), Deep-Fried Dough Sticks syndrome rate lower (p= 0.041). Conclusion: plaques of basal symptoms The maximum load is the main quadrant of the side wall, the vertical distribution in the anterior inferior cerebellar artery opening of the distal common. No symptomatic basilar atherosclerosis focal remodeling with constrictive remodeling mainly, but there is no universal remodeling. Using three-dimensional high resolution magnetic resonance imaging characteristics of basal artery plaque distribution and arterial remodeling helps to reveal the development of intracranial atherosclerosis process and to evaluate the risk of ischemic stroke.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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