症状性颈内动脉AS分布及形态学特征的高分辨率MRI影像学分析

High-resolution MRI imaging analysis of AS distribution and morphological characteristics of symptomatic internal carotid artery

目的探讨症状性颈内动脉硬化性狭窄(AS)分布及形态学特征的高分辨率MRI影像学表现。方法将2017年1月-2019年12月本院收治的100例症状性颈内动脉AS患者纳入研究,对所有纳入对象分别进行弥散加权成像(DWI),三维时间飞跃法头颅磁共振血管成像(3DTOF-MRA)以及高分辨率MRI检查;将所有受试者按照DWI检查表现的差异分为短暂性脑缺血发作(TIA)组43例以及急性脑梗死(ACI)组57例;比较2组基线资料、血管、斑块分布情况、斑块形态学特征以及相关定量指标水平。结果TIA组与ACI组在各项基线资料方面比较均无明显差异(P均>0.05);TIA组与ACI组斑块位于腹侧壁、上侧壁、背侧壁以及下侧壁的人数占比均无明显差异(P均>0.05);TIA组斑块面积、狭窄率及斑块负荷百分比均低于ACI组,且斑块表面不光整的人数占比亦低于ACI组(P均<0.05);TIA组LAMLN高于ACI组,而WAMLN低于ACI组(P均<0.05)。结论ACI患者的AS负荷大于TIA患者,且最大狭窄处的管壁厚度更大,表面更不光整。

Objective To study high-resolution MRI imaging manifestations of the distribution and morphological features of symptomatic internal carotid arteriosclerotic stenosis(AS).Methods 100 symptomatic internal carotid artery AS patients admitted to our hospital from January 2017 to December 2019 were included in the study.Diffusion weighted imaging(DWI),3 DTOF-MRA and high-resolution MRI were performed on all included subjects.All subjects were divided into transient ischemic attack(TIA)group(43 cases)and acute cerebral infarction(ACI)group(57 cases)according to the difference of DWI manifestations.Baseline data,plaque distribution,vascular and plaque morphological characteristics,and relevant quantitative parameters were compared between the two groups.Results The comparison of baseline data between TIA group and ACI group was not significant(all P>0.05).There were no significant difference in the proportions of the numbers of plaques located in the ventral wall,the upper wall,the dorsal wall and the lower wall between the TIA group and the ACI group(all P>0.05).The plaque area,stenosis rate and percentage of plaque load in the TIA group were all lower than those in the ACI group,and the proportion of people with the rough surface of plaque in the TIA group was lower than that in the ACI group(all P<0.05).LAMLN in TIA group was higher than that in ACI group,while WAMLN was lower than that in ACI group(all P<0.05).Conclusion The AS load of patients with ACI was greater than that of patients with TIA,and the wall thickness at the maximum stenosis was larger and the surface was more uniform.