基底动脉弯曲角度与其斑块形成相关性研究

The correlation analysis between basilar artery bending angles and its plaque formation

目的应用三维时间飞跃法磁共振成像(three dimensions time of flight magneticresonance angiography,3D TOF MRA)及高分辨磁共振成像(high resolution magneticresonance imaging,HR-MRI)探讨基底动脉(basilar artery,BA)角度与其斑块形成的相关性。材料与方法回顾性分析我院神经内科自2015年10月至2018年6月经扩散加权成像(diffusion weighted imaging,DWI)检查证实的新发孤立性脑桥梗死患者临床及影像学资料。基于3D TOF MRA的BA角度分为侧角(前后位视图)及前角(侧位视图)。BA责任斑块定义为脑桥梗死同一层面或邻近梗死上下层面的BA斑块,而斑块位置分为腹侧壁、背侧壁、侧壁(左或右)。根据有无BA斑块将急性孤立性脑桥梗死患者分为无斑块组(22例)及有斑块组(75例),应用单因素分析及多因素二元Logistic回归分析寻找BA斑块形成的独立危险因素;斑块分布的组间比较采用单因素方差分析(one-way ANOVA)。结果所有急性孤立性脑桥梗死患者中无BA斑块22例(23%)、存在BA斑块75例(77%),其中腹侧壁3例(3%)、背侧壁41例(42%)、侧壁31例(32%)。单因素分析结果显示,BA侧角、BA前角、出院改良Rankin量表(modified Rankin Scale,mRS)评分在有斑块组与无斑块组的组间差异有统计学意义(P<0.05)。多因素二元Logistic回归分析结果显示,BA侧角及前角是BA斑块形成的独立危险因素(BA前角:OR值=0.095,95%CI=1.032~1.171;BA侧角:OR值=0.132,95%CI=1.053~1.236)。BA侧角及前角在BA斑块分布(无斑块、腹侧壁、背侧壁、侧壁)的组间差异有统计学意义(P=0.002、0.000)。结论 BA前角(侧位视图)越大,BA斑块更可能在背侧壁形成;BA侧角(前后位视图)越大,BA斑块更可能在侧壁形成。

Objective: To investigate the correlation between basilar artery (BA) bending angles and plaque formation with three dimensions time of flight magnetic resonance angiography (3D TOF MRA) and high resolution magnetic resonance imaging (HR-MRI).Materials and Methods: Clinical and imaging data of patients with new isolated pontine infarctions confirmed by diffusion weighted imaging (DWI) from October 2015 to June 2018 were retrospectively collected.The BA angles were divided into the lateral angles (from the anteroposterior view) and anterior angles (from the lateral view) on the 3D TOF MRA image.BA culprit plaque was defined as if it was on the same slice or adjacent upper or lower slice of pontine infarcts.BA plaque location was divided into ventral,dorsal,and lateral (left or right) sides of the vessel.All patients were divided into no plaque group (22 cases) and plaque group (75 cases) according to whether there was BA plaque or not.Univariate analysis and multivariate Logistic regression analysis were performed to explore the independent factors associated wirh the presence of BA plaque.One-way analysis of variance was used to compare the variables of BA plaque location (no plaque,ventral,dorsal,lateral).Results: There were 22 patients (23%) without BA plaques and 75 patients (77%) with BA plaques.BA plaques were located at ventral wall (3%,n=3), dorsal wall (42%,n=41),lateral wall (32%,n=31).Univariate analysis showed there were significant difference in BA lateral angles,BA anterior angles and discharge modified Rankin Scale (mRS) score between patients with and without a BA plaque (P<0.05).Multivariate Logistic regression analysis showed BA lateral angles and anterior angles were independent risk factors for plaque formation (BA anterior angle: OR value=0.095,95%CI=1.032-1.171;BA lateral angle: OR value=0.132,95%CI=1.053-1.236).There were significant differences in anterior angles and lateral angles between different BA plaque location (no plaque,ventral,dorsal and lateral).Conclusions: Greater the anterior angle (from the lateral view) may enhance dorsal plaque formation.Greater the lateral angle (anteroposterior view) may enhance lateral plaque formation.