MRI评估缺血性脑卒中患者颈动脉粥样硬化斑块成分及负荷与缺血征象的相关性

The Correlation Between Composition and Load of Carotid Atherosclerotic Plaque Evaluated By MRI and Ischemic Signs in Patients with Ischemic Stroke

目的探讨MRI评估缺血性脑卒中患者颈动脉粥样硬化斑块成分及负荷与缺血征象的相关性。方法选取我院收治的缺血性脑卒中患者67例,收集影像学资料,依据是否出现缺血征象区分患者卒中侧、非卒中侧,比较不同颈动脉侧斑块成分发生情况及体积、斑块负荷指标水平。结果本组研究共获得126侧颈动脉图像,卒中侧79根,非卒中侧47根。非卒中侧含有脂质的坏死核、斑块内出血发了率明显低于卒中侧(P<0.05);卒中侧含有脂质的坏死核及斑块内出血体积明显大于非卒中侧(P<0.05);不同侧血管总面积、管腔面积、最小管腔面积指标比较无明显差异(P>0.05);卒中侧管壁面积、管壁厚度、管壁标准化指数、最大管壁面积、最大管壁厚度、最大管壁标准化指数明显高于非卒中侧(P<0.05)。结论MRI各序列扫描可有效评估缺血性脑卒中患者颈动脉粥样硬化斑块成分及负荷情况,成分复杂或负荷越高者缺血征象出现率越高。

Objective To investigate the correlation between composition and load of carotid atherosclerotic plaque evaluated by MRI and ischemic signs in patients with ischemic stroke.Methods 67 patients with ischemic stroke admitted to our hospital from January 2016 to December 2017 were selected.The imaging data of patients were collected and the stroke side and non-stroke side were differentiated according to whether there were ischemic sign.The occurrence of plaque components,volume and index levels of plaque load in different carotid side were compared.Results 126 carotid artery images were obtained,with 79 on the stroke side and 47 on the non-stroke side.The incidence of lipid rich necrotic core and intraplaque hemorrhage in non-stroke side was significantly lower than that in stroke side(P<0.05).The volume of intraplaque hemorrhage and lipid rich necrotic core in stroke side was significantly larger than that in non-stroke side(P<0.05).There was no significant difference in total area of blood vessels,lumen area and minimum lumen area between different sides(P>0.05).The wall area,wall thickness,standardization index of wall,maximum wall area,maximum wall thickness and maximum wall standardization index of stroke side were significantly higher than those of non-stroke side(P<0.05).Conclusion MRI sequence scanning can effectively assess the composition and load of carotid atherosclerotic plaques in patients with ischemic stroke.The more complex or higher the load components are,the higher the incidence of ischemic signs is.