2型糖尿病伴缺血性卒中患者基底动脉VW-MRI成像的临床应用

Clinical application of high-resolution vessel wall magnetic resonance imaging in basilar artery of patients with type 2 diabetes mellitus and ischemic stroke

探讨高分辨磁共振颅内动脉管壁成像(VW-MRI)技术在2型糖尿病(T2DM)伴缺血性卒中患者基底动脉(BA)管壁成像的临床应用。收集76例本院临床初步诊断为后循环缺血性卒中患者的VW-MRI影像资料,排除图像质量差或部分序列图像缺失的病例,最终入选患者55例,其中T2DM组22例、非T2DM组33例,观测BA管壁情况。结果显示,与非T2DM组比较,T2DM组BA具有更大的血管面积(VA)、管壁面积(WA)(P<0.05),两组中的斑块位置分布差异有统计学意义(P<0.05),T2DM组斑块分布以背侧壁居多,非T2DM组斑块分布以侧壁居多。结果表明,T2DM患者BA具有更大的动脉负荷,可能更容易发生颅内动脉硬化和管壁正性重构,斑块位置更容易引起穿支动脉开口堵塞,进而导致桥脑梗死。

To investigate the application value of high-resolution vessel wall magnetic resonance imaging(VW-MRI)for basilar artery wall imaging in patients with type 2 diabetes mellitus(T2DM)complicated with ischemic stroke.The VW-MRI imaging data of 76 patients with posterior circulation ischemic stroke or transient ischemic attack diagnosed in our hospital were collected,and the cases with poor image quality or partial sequence image missing were excluded.A total of 55 patients were included in the final analysis of the image data.The patients were divided into two groups:22 cases in T2DM group,33 cases in non-T2DM group.The wall structure of basilar artery was observed.In comparison between T2DM group and non-T2DM group,the BA of the T2DM group had a significantly greater mean VA and WA(P<0.05),and there was a significant difference in the location of plaques between the two groups(P<0.05),the BA plaques in T2DM patients were more frequently located at the dorsal walls,the non-T2DM group had their plaques distributed more likely at the lateral walls.The results showed that BA in patients with T2DM had larger arterial load,more likely to have intracranial arteriosclerosis and positive vascular wall remodeling,locations of the plaque were more likely to block the opening of the perforating artery and lead to pontine infarction.