HR-MRI技术评价吸烟因素对男性症状性大脑中动脉粥样硬化患者局部血管及斑块特征的影响

HR-MRI Technology Evaluation Effects of Smoking on Local Vascular and Plaque Characteristics in Male Patients with Symptomatic Middle Cerebral Artery Atherosclerosis

目的利用高分辨率核磁共振成像(High-resolution magnetic resonance imaging,HR-MRI)技术评价吸烟因素对男性症状性大脑中动脉粥样硬化狭窄患者局部血管及斑块特征的影响。方法回顾性收集2016年10月至2018年10月因出现大脑中动脉供血区缺血事件在北京大学航天临床医学院男性住院患者,依据吸烟与否进行分组,所有患者住院期间均先后完成常规MRI及HR-MRI检查,比较组间HR-MRI图像上获取的局部血管及斑块特征。结果共计入组46例患者,其中吸烟29例(63%),吸烟组与非吸烟组在局部血管指标上均无统计学意义(P>0.05);从局部斑块指标中,斑块负荷、斑块厚度、斑块长度及所在象限个数无统计学差异(P>0.05);两组患者的斑块分布位置同样无统计学差异(P=0.319);两组患者在斑块表面是否连续及斑块是否强化指标上存在统计学差异(P<0.05),吸烟组患者斑块出现表面不连续及强化现象更为多见。结论吸烟因素对症状性大脑中动脉粥样硬化患者的局部血管及斑块特征的影响存在差异:对局部血管狭窄程度影响不明显,更可能通过影响局部斑块稳定性继而造成缺血事件的发生。

Objective To evaluate the effects of smoking factors on local vascular and plaque characteristics in male patients with symptomatic middle cerebral artery atherosclerotic stenosis using high-resolution magnetic resonance imaging(HR-MRI).Methods Retrospectively collected male inpatients from the Peking University Aerospace Clinical Medical College from October 2016 to October 2018 due to the occurrence of ischemic events in the middle cerebral artery supply area.According to the grouping of smoking or not,all patients underwent routine MRI and HR-MRI examinations during hospitalization,and the local vascular and plaque characteristics obtained from HR-MRI images were compared.Results A total of 46 patients were enrolled,including 29(63%)who smoked.There was no significant difference in local vascular indexes between the smoking group and the non-smoking group(P>0.05).From the local plaque index,there was no significant difference in plaque burden,the thickness of the block,the length of the plaque and the number of quadrants(P>0.05).There was no significant difference in the location of plaque between the two groups(P=0.319).Whether the two groups were continuous on the plaque surface and there was a statistical difference in the plaque enhancement(P<0.05).It was more common in patients with smoking to have surface discontinuities and enhancement.Conclusion Smoking factors have different effects on local vascular and plaque characteristics in patients with symptomatic middle cerebral artery atherosclerosis:the effect on local vascular stenosis is not obvious,and it is more likely to cause ischemic events by affecting local plaque stability.