缺血性脑卒中患者颈动脉易损斑块磁共振表现

Magnetic resonance findings of carotid vulnerable plaques in patients with ischemic stroke

目的探讨缺血性脑卒中患者颈动脉易损斑块MR诊断价值。方法经颅MRI证实的首发或再发缺血性脑卒中患者并经过B超检查筛选颈动脉狭窄38例,分别行MR多序列及多期动态增强扫描。结果经MR图像分析,颈总动脉分叉区狭窄20例,颈内动脉狭窄或者闭塞18例,钙化8例,无钙化纤维成分为主19例,明显脂质核心6例,斑块内出血2例,脂质坏死核心2例,溃疡或者纤维帽撕裂1例。结论 MR多序列及多期动态增强扫描对颈动脉易损斑块成分显示清晰,能够动态观察易损斑块变化情况。

Objective To investigate the value of magnetic resonance（ MR） in the diagnosis of carotid vulnerable plaques in patients with ischemic stroke. Methods A total of 38 patients with first-episode or recurrent ischemic stroke confirmed by brain MR imaging and carotid stenosis confirmed by ultrasonography were selected,and multi-sequence and multi-phase dynamic contrast-enhanced MR scanning was performed for all the patients. Results Analysis of MR images showed that there were 20 cases of common carotid artery bifurcation stenosis,18 cases of internal carotid artery stenosis or occlusion,8 cases of calcification,19 cases without calcified fibers,6 cases of obvious lipid core,2 cases of intraplaque hemorrhage,2 cases of lipid / necrotic core,and 1 case of ulcer or fibrous cap rupture. Conclusions Multi-sequence and multi-phase dynamic contrast-enhanced MR scanning can clearly display the composition of carotid vulnerable plaques and observe the changes of vulnerable plaques.