有症状大脑中动脉动脉粥样硬化性狭窄患者的血管壁重构模式与斑块强化的关系

Relationship between remodeling patterns and plaque enhancement in patients with symptomatic atherosclerolic middle cerebral artery stenosis

目的 探讨有症状大脑中动脉（middle cerebral artery,MCA）动脉粥样硬化性狭窄患者血管壁重构模式与斑块强化的关系.方法 2015年8月至2016年6月表现为缺血性卒中或短暂性脑缺血发作的单侧MCA动脉粥样硬化性狭窄患者行常规MRI和黑血MRI.测量MCA动脉粥样硬化性狭窄处管壁和管腔面积,计算狭窄程度和重构指数.结果 总共33例的图像纳入分析,11例斑块明显强化,其中9例为正性重构,2例为负性重构;22例斑块无明显强化,其中正性重构5例,无重构5例,负性重构12例.斑块明显强化组以正性重构为主（81.8％对22.7％）,斑块无明显强化组以负性重构为主（54.5％对18.2％）,差异有统计学意义（P=0.018）.结论 MCA动脉粥样硬化性狭窄处斑块明显强化者以正性重构为主,反映了斑块的不稳定性.

 Objective To investigate the relationship between vascular remodeling patterns of atherosclerotic middle cerebral artery （MCA） stenosis and plaque enhancement.Methods From August 2015 to June 2016,patients with unilateral symptomatic atherosclerotic MCA stenosis underwent routine MRI and black blood magnetic resonance inaging examinations.The vessel area and lumen area of MCA at the site of atherosclerotic MCA stenosis were measured,and the degree of MCA stenosis and the remodeling index were calculated.Results A total of 33 patients were included.Eleven had obvious plaque enhancement,including 9 positive remodeling and 2 negative remodeling;22 did not have plaque enhancement,including 5 positive remodeling,5 no remodeling,and 12 negative remodeling.The obvious plaque enhancement group was mainly positive remodeling （81.8% vs.22.7%）,and the no obvious enhancement group was mainly negative remodeling （54.5% vs.18.2%）.The difference was statistically significant （P=0.018）.Conclusion Plaque enhancement at the site of atherosclerotic MCA stenosis is mainly positive remodeling,which reflects plaque instability.