高分辨率磁共振大脑中动脉粥样硬化斑块强化程度与脑梗死关系的研究

The correlation between enhancement of middle cerebral artery atherosclerotic plaques and cerebral infarction:a high resolution MRI study

目的利用高分辨率磁共振(HRMRI)成像方法,探讨大脑中动脉(MCA)粥样硬化斑块的强化程度与脑梗死之间的关系。方法收集2015年8月~2016年6月34例有临床症状的MCA粥样硬化性狭窄的患者,行常规头颅MR检查及狭窄处黑血序列T1WI、T2WI、增强T1WI扫描。将弥散加权成像上MCA供血区出现高信号的患者归入急性脑梗组,无高信号的患者归入无急性脑梗组。将增强后斑块的强化程度分为明显强化、轻度强化、无强化,比较两组间斑块强化程度的差异。结果 34例图像用于分析,急性脑梗组15例,无急性脑梗组19例。急性脑梗组有11例明显强化、1例轻度强化、3例无强化;无急性脑梗组有1例明显强化、4例轻度强化、14例无强化。两组间斑块的强化程度有差异,急性脑梗组的明显强化斑块多于无急性脑梗组(P=0.000);无强化斑块少于无急性脑梗组(P=0.005)。结论 HRMRI可以定性评估MCA粥样硬化斑块的强化程度;斑块的明显强化更多见于急性脑梗组,提示其不稳定性,可预测脑卒中的风险。

Objective To investigate the correlation between enhancement of middle cerebral artery （ MCA） atherosclerotic plaques and cerebral infarction using high resolution magnetic resonance （ HRMRI） . Methods Thirty-four consecutive patients with atherosclerotic MCA stenosis were imaged with a 3. 0 T MR scanner. The HRMRI protocol included black blood T1-weighted imaging, T2-weighted imaging, contrast enhancement T1 WI. The patients with hyperintense on diffusion-weighted imaging （ DWI） in distrilution of stenotic MCA were classified into acute infarction group;the others without hyperintense on DWI were enrolled in the non-acute infarction group. The degree of plaques enhancement was divided into obvious enhancement, mild enhancement, no enhancement. Then, the difference between acute infarction group and non-acute infarction group was compared. Results Acute infarction group had 15 cases, in which there were 11 cases in obvious enhancement, 1 case in mild enhancement, and 3 cases without enhancement;non-acute infarction group had 19 cases, in which these were 1 case in obvious enhancement, 4 cases in mild enhancement, and 14 cases without enhancement. The degree of plaques enhancement between two groups had statistical difference . The acute infarction group had more obvious enhancement plaques （ P = 0 . 000 ） , and less no enhancement plaques （ P =0. 005）. Conclusion HRMRI could qualitatively assess enhancement of MCA atherosclerotic plaques, obvious enhance-ment plaques are more common in acute infarction group, indicating it＇ s instability.