磁共振管壁成像评价老年人胸主动脉粥样硬化斑块的特征

发布时间：2018-03-25 05:13

本文选题：动脉粥样硬化　切入点：主动脉　出处：《中国医学影像学杂志》2017年08期

【摘要】：目的胸主动脉粥样硬化斑块是老年人缺血性卒中栓子的重要来源。本研究拟应用三维磁共振管壁成像技术评价老年人胸主动脉粥样硬化易损斑块的特征,从而积极预防心脑血管并发症的发生。资料与方法前瞻性选取60岁以上且无任何严重心脑血管症状的老年人53例,分为60~74岁组(A组)和75~89岁组(B组)。全部受试者均接受磁共振胸主动脉管壁多对比度序列扫描。将胸主动脉分为升主动脉段、主动脉弓段和降主动脉段3个节段,评价其粥样硬化斑块的特征。定量测量老年人群胸主动脉粥样硬化斑块的负荷特征,并定性分析其成分特征。结果老年人胸主动脉粥样硬化斑块内出血的发生率为26.4%(14/53),脂质核的发生率为94.3%(50/53)。同时,B组升主动脉段、主动脉弓段和降主动脉段3个节段的最大管壁厚度均显著大于A组[(3.1±0.6)mm比(3.0±0.4)mm,P0.05;(3.2±0.7)mm比(3.1±0.7)mm,P0.05;(3.0±0.8)mm比(2.9±0.7)mm,P0.001];B组3个节段的标准化管壁指数均显著大于A组[(26.9±3.5)%比(26.7±2.9)%,P0.001;(31.9±5.1)%比(31.0±5.1)%,P0.001;(34.6±5.0)%比(34.1±4.6)%,P0.001]。结论老年人胸主动脉粥样硬化斑块内出血的发生率较高,且斑块负荷随年龄增长而逐渐增大。因此,应用磁共振管壁成像早期识别老年人胸主动脉的易损斑块,将有助于脑卒中的预防及治疗。
[Abstract]:Objective Atherosclerotic plaque of thoracic aorta is an important source of embolus in elderly patients with ischemic stroke. Data and methods 53 elderly patients over 60 years of age without any serious cardiovascular and cerebrovascular symptoms were selected prospectively to prevent the occurrence of cardiovascular and cerebrovascular complications. They were divided into group A (60 ~ 74 years old) and group B (75 ~ 89 years old). All subjects were scanned with magnetic resonance multiple contrast sequence. The thoracic aorta was divided into three segments: ascending aorta segment, aortic arch segment and descending aortic segment. To evaluate the characteristics of atherosclerotic plaques and to measure quantitatively the load characteristics of atherosclerotic plaques in the thoracic aorta of the elderly. Results the incidence of intracerebral hemorrhage of thoracic aortic atherosclerotic plaque in the elderly was 26.4%, and the incidence of lipid nucleus was 94.33 / 50 / 53. At the same time, the ascending aortic segment in group B. The maximum wall thickness of three segments of aortic arch and descending aorta in group B was significantly larger than that in group A [3.1 卤0.6)mm vs 3.0 卤0.4mm P0.05U / 0.7)mm vs 3.1 卤0.7mm P0.05ng / 0.8)mm vs 2.9 卤0.7mm / P0.001]. Conclusion the standardized wall index of three segments of group B is significantly higher than that of group A [26.9 卤3.5% vs 26.7 卤2.9 卤2.9mm / P = 31.9 卤5.1% vs 31.0 卤5.1g / 31.0 卤5.1g / 34.6 卤5.0g% vs 34.1 卤4.6p0.001] .Conclusion there is no significant difference between group A and group A [26.9 卤3.5U% vs 26.7 卤2.9mm / P > 31.9 卤5.1% vs 31.0 卤5.1U% vs 34.6 卤5.0g% vs 34.1 卤4.6p0.001]. The incidence of intracerebral hemorrhage in atherosclerotic plaque was higher. The plaque load increases with age. Therefore, the early identification of vulnerable plaques in the thoracic aorta of the elderly by magnetic resonance wall imaging will be helpful to the prevention and treatment of stroke.
【作者单位】：扬州大学第二临床医学院放射科;清华大学生物医学工程系生物医学影像研究中心;东南大学附属中大医院放射科;美国华盛顿大学放射科;
【基金】：国家自然科学基金(81271536)
【分类号】：R445.2;R543.1

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