HR-MRI在复发性脑卒中患者中的应用

The Application of HR-MRI in Patients with Recurrent Stroke

目的应用3.0T高分辨磁共振(HR-MRI)分析复发性脑卒中颈动脉斑块特征。方法回顾性收集2015年6月-2017年3月我院68例急性缺血脑卒中患者临床资料,所有患者均行3.0T HRMRI检查,根据既往是否存在缺血性脑卒中发作史分为初发组(n=32)和复发组(n=36),比较两组斑块负荷及斑块成分差异。结果斑块负荷上,两组管腔面积、管壁面积、管壁厚度、血管总面积、管腔狭窄率比较差异无统计学意义(P>0.05),但复发组较初发组管壁标准化指数(NWI)明显增高(P<0.05)。斑块成分上,两组斑块脂质坏死核心、钙化比例比较差异无统计学意义(P>0.05),但复发组较初发组斑块内出血、纤维帽破裂比例明显增大(P<0.05)。结论 HR-MRI可有效评估复发脑卒中患者颈动脉斑块特征,对脑卒中再发风险评估及预防有着重要意义。

Objective To analyze the characteristics of carotid plaques in patients with recurrent stroke by 3.0 T high resolution magnetic resonance imaging（HR-MRI）. Methods The clinical data of 68 patients with acute ischemic stroke who were admitted to the hospital from June 2015 to March 2017 were analyzed retrospectively. All patients were examined by 3.0 T HR-MRI. According to the history of ischemic stroke, the patients were divided into the primary attack group（n=32） and the recurrence group（n=36）. The plaque load and plaque composition were compared between the two groups. Results There was no significant difference in the area of lumen, the area and thickness of wall, total vessel area and lumen stenosis rate between the two groups（P〉0.05）, but the normalized wall index（NWI） of the recurrence group was significantly higher than that of the primary attackgroup（P〉0.05）. In terms of plaque composition, there was no significant difference between the two groups in plaque lipid necrosis core and calcification ratios（P〈0.05）, but the proportions of bleeding in plaque and fibrous cap rupture in the recurrence group were significantly higher than those in the primary attack group（P〈0.05）.Conclusion HR-MRI can effectively evaluate the characteristics of carotid artery plaques in patients with recurrent stroke, which is of great significance for the risk assessment and prevention of recurrent stroke.