脑桥梗死的基底动脉粥样硬化斑块分布及形态学特征的高分辨血管壁成像研究

Study of high resolution vessel wall imaging of basilar artery atherosclerotic plaque distribution and morphological features in pontine infarction

目的探讨急性脑桥梗死不稳定斑块的高分辨血管壁成像(high resolution vessel wall imaging,HR-VWI)影像特点。方法回顾性分析2016年6月-2019年11月在深圳市宝安区人民医院有症状急性脑桥梗死39例和无症状脑桥梗死45例患者,在HR-VWI上统计基底动脉(basilar artery,BA)斑块分布、斑块累及象限、斑块表面连续情况;定量测量斑块长度、血管体积(Vouter)、血管壁体积(V wall)、管腔最狭窄层内管腔直径(LD MLN)、外管腔最大直径(OD MLN)、血管面积(OA MLN)、血管壁面积(WA MLN)、最厚厚度(WTmax),并计算斑块负荷(PB)、管腔狭窄率,比较两组的测量指标。结果两组之间的斑块分布、斑块不连续、WTmax、WA MLN、PB、BA管腔狭窄率有统计学意义(P<0.05)。结论有症状脑桥梗死的BA斑块更容易分布于侧壁,表面更不连续、更厚斑块厚度、更大的血管面积和斑块负荷,更高的管腔狭窄率,提示其具有不稳定斑块特征。

Objective To investigate the characteristics of high resolution vessel wall imaging(HR-VWI)imaging of unstable plaques in acute pontine infarction.Methods Data from thirty-nine patients with symptomatic acute pontine infarction and 45 patients with asymptomatic pontine infarction in the Peopl’s Hospital of Baoan District,Shenzhen from June 2016 to November 2019 was retrospectively analyzed.The distribution of BA plaques and plaque involvement were counted on HR-VWI Quadrant.Plaque surface continuity,plaque length,vascular volume(Vouter),vascular wall volume(V wall),lumen diameter in the narrowest layer of the lumen(LD MLN),maximum diameter of the outer lumen(OD MLN),vascular area(OA MLN),vascular wall area(WA MLN),the thickest thickness(WTmax),the plaque load(PB),and lumen stenosis rate were measured.Measurement indicators were compared between the two groups.Results The plaque distribution,plaque discontinuity,WTmax,WA MLN,PB,and BA lumen stenosis rates between the two groups were statistically different(P<0.05).Conclusions BA plaques with symptomatic pontine infarction are more likely to be distributed on the side wall,the surface is more discontinuous,thicker plaque thickness,larger blood vessel area and plaque load,higher luminal stenosis rate,suggesting that it has instability Plaque characteristics.