磁共振黑血技术及MSCTA对颈动脉斑块特征的研究

Study of the characteristics of carotid artery plaque with black blood magnetic resonance imaging and MSCTA

目的探讨磁共振黑血技术(black blood magnetic resonance imaging,BB-MRI)及多层螺旋CT(multi-slice spiralcomputed angiography,MSCTA)对颈动脉斑块特征的研究,并探讨两者与经颈动脉内膜剥脱术(carotid endarterectomy,CEA)剥脱下斑块的病理对照及对颈动脉斑块临床治疗的指导作用。方法收集20例行超声检查有颈动脉斑块者,其中15例均行BB-MRI及CTA检查,3例仅行CTA检查,2例仅行BB-MRI检查。其中18例行颈动脉内膜剥脱术(CEA),2例行颈动脉支架成形术(carotid angioplasty and stenting,CAS)。MSCTA、BB-MR与从CEA中剥脱斑块的病理组织学检查结果相比较。结果 MSCTA及BB-MRI对软斑块的诊断率分别为75%、92%。两者对软斑块的检出经统计学检验无明显差异性(P>0.05)。18例从CEA中剥脱下斑块的病理组织与CTA及BB-MRI检查结果相一致。结论 BB-MRI及MSCTA能够对颈动脉斑块的病理学类型做出相关定性的分析,检查结果与CEA标本的组织学密切相关。根据斑块的影像表现及临床相关资料能够为治疗提供依据。

Objective To investigate the characteristic of carotid plaques with black blood magnetic resonance imaging（BB-MRI） and multi-slice spiral computed angiography（MSCTA）,and explore the relationship between carotid endarterectomy（CEA）with them and give guidance to clinical treatment.Methods total of 20 consecutive patients who had undergone carotid US,of which 15 cases underwent BB-MRI and CTA,3 cases underwent CTA examination,only 2 cases by BB-MRI examination.18 cases underwent CEA,2 cases underwent CAS（carotid angioplasty and stenting）.The results with BB-MRI and MSCTA were compared with the specimens from the CEA.Results The diagnosis rates of soft plaques were 75%,92% by MSCTA and BB-MRI.Both the detection rate of soft plaques by statistics test was not significantly different（P0.05）.The results by BB-MRI and MSCTA were consistent with the pathology results.Conclusion BB-MRI and MSCTA can make relevant qualitative analysis to carotid plaques in pathology types,and are closely related to the CEA specimen histology.It can be helpful for selecting methods according to the plaque image manifestations and clinical data.