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与高血脂的相关性

发布时间：2018-05-12 13:42

本文选题：高血脂 + 胸主动脉　；参考：《临床放射学杂志》2017年11期

【摘要】：目的应用磁共振管壁成像技术探讨老年人胸主动脉粥样硬化斑块的特征及其与高血脂的相关性。方法入组人群为60岁以上、且无任何严重心脑血管症状的老年人。所有受试者均进行胸主动脉多对比度磁共振管壁成像。图像判读人员将定量测量高血脂者和血脂正常者胸主动脉粥样硬化斑块的负荷特征,定性分析其成分特征,并探讨这些特征与高血脂的相关性。将胸主动脉分为3段,即升主动脉段(AAO)、主动脉弓段(AOA)以及降主动脉段(DAO)。结果 66例受试者,高血脂组43例,平均年龄(72.7±6.8)岁,其中男19例(44.2%)。高血脂组胸主动脉粥样硬化斑块的发生率显著高于血脂正常组(95.3%vs 60.9%,P=0.001)。同时,富含脂质坏死核(LRNC)的发生率亦显著高于血脂正常组(88.4%vs 52.2%,P=0.001),而斑块内出血/血栓(IPH/MT)的差异无统计学意义(20.9%vs 21.7%,P=0.939)。高血脂组胸主动脉3个节段的管腔面积(LA)均小于血脂正常组,而管壁面积(WA)及最大管壁厚度(maxWT)均大于血脂正常组,且差异均具有统计学意义(P0.05)。另外,胸主动脉AS斑块(OR=-0.311,P=0.011)及LRNC(OR=-0.591,P0.001)均与高密度脂蛋白呈显著负相关。IPH/MT与甘油三酯呈显著正相关(OR=0.25,P=0.043)。结论高血脂的老年人胸主动脉粥样硬化斑块的发生率显著高于血脂正常者,LRNC为其主要成分,并且与高密度脂蛋白的降低显著相关。
[Abstract]:Objective to investigate the characteristics of thoracic aortic atherosclerotic plaque and its correlation with hyperlipidemia in the elderly by magnetic resonance wall imaging. Methods the elderly over 60 years old and without any serious cardiovascular and cerebrovascular symptoms were enrolled in the study. All subjects underwent multi-contrast magnetic resonance wall imaging of thoracic aorta. Image interpreters will quantitatively measure the load characteristics of thoracic aorta atherosclerotic plaques in hyperlipidemia and normolipidemia and qualitatively analyze their component characteristics and explore the correlation between these characteristics and hyperlipidemia. The thoracic aorta was divided into three segments: AAOA, AOAA, and DAOA in descending aorta. Results among 66 subjects, 43 cases were in hyperlipidemia group, with an average age of 72.7 卤6.8 years, of which 19 cases were male. The incidence of atherosclerotic plaque in thoracic aorta in hyperlipidemia group was significantly higher than that in normal blood lipid group (95.3 vs 60.9). At the same time, the incidence of LRNCrich in lipid necrosis nucleus was significantly higher than that in normal blood lipid group (88. 4 vs 52. 22), while there was no significant difference in plaque hemorrhage / thrombus IPH / MTT between 20. 9 vs 21. 7 and 0. 939. The lumen area of three segments of thoracic aorta in hyperlipidemia group was smaller than that in normal blood lipid group, and the wall area (WAA) and maximum wall thickness (maxWTT) were larger than those in normal blood lipid group, and the difference was statistically significant (P 0.05). In addition, there was a significant negative correlation between OR-0.311P0. 011) and LRNCnC OR-0.591 (P0.001). There was a significant positive correlation between IPH / MT and triglyceride. Conclusion the incidence of atherosclerotic plaque in thoracic aorta of the elderly with hyperlipidemia is significantly higher than that with normal blood lipids, LRNC is the main component, and is significantly related to the decrease of high density lipoprotein.
【作者单位】：扬州大学附属医院放射科;东南大学附属中大医院放射科;清华大学生物医学工程系生物医学影像研究中心;美国华盛顿大学放射科;
【分类号】：R445.2;R543.5;R589.2

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