高分辨MRI三维可变翻转角快速自旋回波成像技术在评估大脑中动脉斑块特征与脑梗死发生关系的研究

Evaluation of the Relations Between Ischemic Stroke and Middle Cerebral Artery Plaque Characteristics by Three Dimensional-Sampling Perfection with Application-Optimized Contrasts using Different Flip Angle Evolutions of High-Resolution Magnetic Resonance

目的应用高分辨MRI三维可变翻转角快速自旋回波(3D-SPACE)血管成像技术分析大脑中动脉(MCA)斑块特征,并探讨其与脑梗死发生的关系。方法回顾性分析187例MCA狭窄患者的临床和影像学资料。所有患者均行3D T1-SPACE平扫及增强检查、常规头颅MRI检查。根据影像表现分为梗死组(n=92)与非梗死组(n=95)。分析比较两组的MCA血管狭窄程度、重构模式、斑块位置及分布、斑块负荷、表面是否规则、出血和强化程度。使用Logistics回归分析脑梗死的危险因素。结果脑梗死组MCA血管狭窄程度、斑块负荷和斑块强化程度均明显高于非梗死组(P<0.05)。脑梗死组的斑块表面不规则、偏心性分布、管腔正性重构、斑块内出血的比例均明显高于非梗死组,差异均有统计学意义(P<0.05)。斑块表面不规则(OR=5.71,P<0.001)、管腔正性重构(OR=3.36,P=0.005)是脑梗死的独立危险因素。结论3D-SPACE血管成像可以有效评估MCA狭窄患者动脉斑块特征和预测脑梗死的发生。

Objective To investigate the characteristics of middle cerebral artery plaques in patients with middle cerebral artery atherosclerosis and the relationship between plaque characteristics and cerebral infarction by three dimensional-sampling perfection with application-optimized contrasts using different flip angle evolutions of high-resolution magnetic resonance imaging.Methods The clinical and imaging studies of the 187 patients with middle cerebral artery stenosis were retrospectively analyzed.All patients performed 3 D T1-SPACE and conventional MRI examination.All patients were divided into cerebral infarction and non-cerebral infarction groups based on the presence or absence of cerebral infarction on conventional MRI.The stenosis rate,remodeling index,and plaque characteristics including burden,location,distribution,surface,hemorrhage and degree of enhancement were analyzed and compared between these two groups on 3 D T1-SPACE.The independent risk factor of the cerebral infarction was analyzed by logistic regression.Results The stenosis rate,plaque burden and enhancement degree of MCA plaque in cerebral infarction group were significantly higher than those in non-cerebral infarction group(all P<0.05).The irregular surface plaques,eccentric lesions,positive remodeling and plaque hemorrhage were more common in patient with cerebral infarction compared with the patients with non-cerebral infarction(all P<0.05).Positive remodeling(OR=5.71,P<0.001)and irregular surface of plaques(OR=3.36,P=0.005)were independent risk factors for cerebral infarction.Conclusion 3 D-SPACE vessel imaging can effectively evaluate the plaque characteristics and predict the occurrence of cerebral infarction.