缺血性脑卒中患者颈动脉血管壁磁共振检查的临床意义

Clinical value of magnetic resonance imaging of carotid vessel wall in ischemic stroke patients

目的评价颈动脉血管壁磁共振检查在缺血性脑卒中的临床意义。方法 67例缺血性脑卒中患者,其中男性55例,女性12例,平均年龄64岁（46~81岁）;31例同期住院的非缺血性脑卒中患者作对照,其中男性26例,女性5例,平均年龄65岁（44~80岁）。对两组患者行颈动脉血管壁磁共振检查,比较两组人群的颈动脉粥样硬化病变分型和管壁定量指标差异。结果缺血性脑卒中组颈动脉的最大血管总面积[（99.3±20.9）mm2]、最大管壁厚度[（4.1±1.3）mm]和最大管壁标准化指数（0.57±0.11）均明显高于对照组[（59.9±13.3）mm2、（2.9±1.1）mm、0.40±0.09]（P均〈0.05）。缺血性脑卒中组的颈动脉复杂斑块（Ⅳ-Ⅴ型和Ⅵ型）的发生率高于对照组。结论颈动脉血管壁磁共振检查能有效筛查缺血性脑卒中患者的颈动脉粥样硬化病变,并为临床提供有价值信息。

Objective To evaluate the clinical value of magnetic resonance imaging（MRI） of carotid vessel wall in ischemic stoke patients.Methods A total of 67 ischemic stroke patients（ischemic stroke group,male 55,female 12,aged 46-81 years old,mean age 64 years old） and 31 control cases（control group,male 26,female 5,aged 44-80 years old,mean age 65 years old） were enrolled,which were performed MRI of carotid vessel wall.The carotid atherosclerotic lesion type and plaque burden were compared between 2 groups.Results The maximum total vascular area[TVAmax（99.3 ± 20.9） mm2],maximum wall chickens[WTmax（4.1 ± 1.3） mm] and maximum normalized wall index（NWImax 0.57 ± 0.11） in ischemic stroke group were significantly higher than those of control group[TVAmax（59.9 ± 13.3） mm2,WTmax（2.9 ± 1.1） mm and NWImax（0.40 ± 0.09）]（P 0.05）.The occurrence rate of carotid arteries complex and carotid artery plaque（type Ⅳ-Ⅴand type Ⅵ） in ischemic stroke group was higher than that in control group.Conclusion It is demonstrated that MRI of carotid vessel wall is capable of screening the atherosclerotic lesions in ischemic stroke patients,and providing effective clinical values.