3.0T MRI颈动脉斑块高分辨成像在IS患者中的应用价值分析

Application Value Analysis of 3.0T MRI Carotid Plaque High Resolution Imaging on Patients with IS

目的采用3.0T MRI颈动脉斑块高分辨成像评价缺血性脑卒中(IS)患者高危斑块特征及其与IS的关系。方法将我院90例IS患者作为研究对象,均进行颈动脉3.0TMRI多序列检查,分析比较症状侧和非症状侧颈动脉斑块负荷、斑块内成分及体积。结果症状侧平均血管总面积(TVAmean)和非症状侧无显著差异(P>0.05),平均管腔面积(LAmean)、最小管腔面积(LAmin)均小于非症状侧(P<0.05),平均管壁面积(WAmean)、最大管壁厚度(WTmax)、平均管壁标准化指数(NWImean)、最大管壁标准化指数(NWImax)均大于非症状侧(P<0.05)。症状侧颈动脉斑块钙化、富含脂质的坏死核、斑块内出血比例均高于非症状侧(P<0.05),纤维帽破裂比例与非症状侧无显著差异(P>0.05)。症状侧颈动脉斑块钙化、富含脂质的坏死核及斑块内出血体积均大于非症状侧(P<0.05)。结论IS的发生与同侧颈动脉粥样硬化负荷、斑块内成分有关,3.0TMRI颈动脉斑块高分辨成像能有效测量IS患者颈动脉斑块负荷、斑块内成分,可作为高危斑块识别重要检测方法。

Objective To evaluate the characteristics of high-risk plaques in patients with ischemic stroke(IS)by high resolution imaging of 3.0T MRI carotid plaque and its relationship with IS.Methods 90 patients with IS in the hospital were enrolled in the study.All patients underwent carotid 3.0T MRI multiple sequence examination.The burden,composition and volume of carotid plaque in the symptomatic side and nonsymptomatic side were analyzed and compared.Results There was no significant difference in the mean total vascular area(TVAmean)between the non-symptomatic side and nonsymptomatic side(P>0.05),The mean lumen area(LAmean)and minimum lumen area(LAmin)were smaller than those in the non-symptomatic side(P<0.05).The mean wall area(WAmean),maximum wall thickness(WTmax),mean normalization wall index(NWImean)and maximum normalization wall index(NWImax)were larger than those in the nonsymptomatic side(P<0.05).The proportion of carotid plaque calcification,lipid-rich necrotic nucleus and bleeding within plaque in the symptomatic side was higher than that in the non-symptomatic side(P<0.05).There was no significant difference in the rate of fibrous cap rupture between the non-symptomatic side and non-symptomatic side(P>0.05).The volume of carotid plaque calcification,lipid-rich necrotic nucleus and bleeding within plaque in the symptomatic side was larger than that in the non-symptomatic side(P<0.05).Conclusion The occurrence of IS is related to load of ipsilateral carotid atherosclerosis and plaque compositions.3.0T MRI carotid plaque high resolution imaging can effectively measure the load of carotid plaque and plaque compositions in IS patients,which can be used as an important detection method for the recognition of high risk plaque.