高分辨MRI对大脑中动脉粥样硬化斑块分布特点及稳定性的研究

Research on Distribution Characteristics and Stability of Atherosclerotic Plaques in the Middle Cerebral Artery by HR-MRI

目的通过高分辨MRI(HR-MRI)探讨大脑中动脉粥样硬化斑块的分布特点及斑块性质。方法前瞻性纳入经颅脑MRA检查证实大脑中动脉M1段有粥样硬化斑块的患者52例,所有病例均为单侧发病。依据DWI及临床表现分为症状性组(27例)和非症状性组(25例),对大脑中动脉动脉粥样硬化斑块处行HR-MRI扫描。结果症状性组27例,21例为易损性斑块;非症状性组25例,11例为易损性斑块。两组比较易损性斑块的发生率差异有统计学意义(P=0.012)。症状性组斑块最大厚度为(1.80±0.33)mm,非症状性组斑块最大厚度为(1.51±0.37)mm,两组比较差异有统计学意义(P=0.004)。大脑中动脉粥样硬化斑块易发生于管腔前壁(22/52),其次为管腔下壁(13/52)。单因素分析症状性组与非症状性组斑块分布部位的差异无统计学意义(P>0.05)。结论HR-MRI可有效的对大脑中动脉粥样硬化斑块进行定位、定量、定性分析,为临床诊断及治疗提供影像依据。

Objective To explore the distribution characteristics and nature of atherosclerotic plaques in the middle cerebral artery（ MCA） through high resolution magnetic resonance imaging（ HR-MRI）. Methods A total of 52 patients were included prospectively,all of whom had atherosclerotic plaques in M1 segment of MCA determined by craniocerebral MRA and all of the cases were lateral onset. The patients were divided into the symptomatic group（ n = 27） and the asymptomatic group（ n = 25） based on DWI and clinical manifestations,and the atherosclerotic plaques of MCA were scanned by HR-MRI. Results 1. Vulnerable plaques were found in 21 cases in the symptomatic group（ 21 /27） and 11 cases in the asymptomatic group（ 11 /25）. There were statistically significant differences between the two groups in the incidence of vulnerable plaque. The maximum plaque thickness was（ 1. 80 ± 0. 33） mm in the symptomatic group while（ 1. 51 ± 0. 37）mm in the asymptomatic group,with statistically significant differences. 2. Atherosclerotic plaques most often occurred in the anterior wall of the MCA（ 22 /52）,followed by the inferior wall（ 13 /52）. Single factor analysis showed that there were no statistically significant differences between the symptomatic group and the asymptomatic group in the distribution of plaques. Conclusion HR-MRI is effective in locating,quantitative and qualitative analysis of the atherosclerotic plaques in the MCA,which provides the imaging basis for clinical diagnosis and treatment.