利用神经血管线圈评价颈动脉出血斑块、纤维斑块与破损斑块的关系

Relationship Between Intraplaque Hemorrhage,Fibrosis and Ruptured Plaque in Carotid Artery using Neurovascular Coil

目的利用神经血管线圈评价颈动脉粥样硬化出血斑块、纤维斑块及破损斑块的关系。资料与方法选择在我院诊断颈内动脉颅外段狭窄的患者52例,利用头颈部神经血管线圈,通过头颈部三维时间飞跃法(3DTOF)磁共振血管造影(MRA)及斑块部位双反转恢复(double inversion recovery,DIR)快速自旋回波(turbo spinecho,TSE)T1WI和T2WI判断颈内动脉颅外段狭窄部位及狭窄程度、粥样硬化斑块有无破损、斑块内出血及纤维成分,将斑块破损组和无破损组内的出血、纤维斑块数量分别行χ2检验,判断两组内的出血、纤维斑块数量差异有无统计学意义。结果 52例中,检测出颈动脉狭窄部位85处,出血斑块18处,纤维斑块54处,破损斑块26处,斑块破损组和无破损组内出血和纤维斑块数量差异均有统计学意义(P<0.05)。结论出血斑块伴发斑块破损概率大,纤维斑块伴发斑块破损概率小,DIR TSE序列可以判断出血斑块和纤维斑块,并有效预测斑块的破损。

Objective To evaluate the relationship between intraplaque hemorrhage, fibrosis and ruptured atherosclerotic plaque in carotid artery with neurovaseular coil. Materials and Methods Fifty two cases with carotid artery stenosis were included in this study. The position and degree of carotid stenosis were determined by 3D TOF MRA and DIR TSE sequences. Intraplaque hemorrhage, fibrosis and rupture of plaques were detected. X2 test was used to statistically analyze the relationship between intraplaque hemorrhage, fibrosis and ruptured plaques. Results Eighteen plaques with intraplaque hemorrhage,54 palques with fibrosis and 26 ruptured plaques were detected. There was difference of intraplaque hemorrhage and fibrosis between the ruptured and intact plaques （ P 〈 0.05 ）. Conclusion Intraplaque hemorrhage and fibrosis can be detected with DIR TSE sequences. The plaques with hemorrhage are easier to rupture than fibrosis plaques, which is helpful to forecast the safe of plaques.