3D T_(1)-SPACE高分辨率磁共振管壁成像诊断脑血管病的价值

Diagnostic value of 3D T_(1)-SPACE high-resolution magnetic resonance vessel wall imaging in cerebrovascular diseases

目的:分析观察三维T_(1)加权可变反转角快速自旋回波(3D T_(1)-SPACE)高分辨率磁共振管壁成像在脑血管病诊断中的应用价值。方法:选择100例缺血性脑血管病患者行3D T_(1)-SPACE高分辨率磁共振管壁成像,根据有无症状分为有症状组(n=61)和无症状组(n=39),比较两组患者血管和斑块量化指标[病变层面血管面积(VA_(MLN))、病变层面管腔面积(LA_(MLN))、参考层面血管面积(VA_(RL))、参考层面管腔面积(LA_(RL))、狭窄率、斑块负荷、重构指数(RI)、偏心指数(EI)以及正性重构、偏心斑块、斑块表面不规则、斑块位置前壁比例],采用Logistic回归模型分析影响症状性动脉粥样硬化大脑中动脉狭窄的独立危险因素。结果:两组VA_(MLN)、LA_(MLN)、VA_(RL)、LA_(RL)、狭窄率以及斑块负荷比较,差异无统计学意义(P>0.05),有症状组RI、EI显著大于无症状组(P<0.05),正性重构、偏心斑块、斑块表面不规则以及斑块位于上壁位置比例显著高于无症状组(P<0.05);Logistic回归分析结果显示,管腔正性重构、斑块表面不规则以及斑块位于上壁位置是影响症状性动脉粥样硬化大脑中动脉狭窄的独立危险因素。结论:3D T_(1)-SPACE高分辨率磁共振管壁成像可有效评估脑血管病患者动脉斑块特征,症状性动脉粥样硬化大脑中动脉狭窄通常伴有管腔正性重构、斑块表面不规则以及斑块位于上壁位置特征,对预测患者发生脑血管意外风险和分级具有指导意义。

Objective To analyze and observe the application value of three-dimensional T_(1) weighted sampling perfection with application-optimized contrast using different flip angle evolutions(3D T_(1)-SPACE)high-resolution magnetic resonance vessel wall imaging in the diagnosis of cerebrovascular diseases.Methods A total of 100 patients with ischemic cerebrovascular diseases who received 3D T_(1)-SPACE high-resolution magnetic resonance vessel wall imaging were enrolled and then divided into symptomatic group(n=61)and asymptomatic group(n=39)according to whether they were symptomatic or not.The quantitative indicators of blood vessels and plaques were compared between two groups of patients,and the indicators included vessel area at lesion level(VA_(MLN)),lumen area at lesion level(LA_(MLN)),vessel area at reference level(VA_(RL)),lumen area at reference level(LA_(RL)),stenosis rate,plaque load,remodeling index(RI),eccentricity index(EI)and the proportions of positive remodeling,eccentric plaque,irregular plaque surface and plaque at the anterior wall.Logistic regression model was used to analyze the independent risk factors affecting middle cerebral artery stenosis of symptomatic atherosclerosis.Results No statistical difference was found between two groups in VA_(MLN),LA_(MLN),VA_(RL),LA_(RL),stenosis rate and plaque load(P>0.05).The RI and EI of symptomatic group were significantly higher than those of asymptomatic group(P<0.05),and the proportions of positive remodeling,eccentric plaque,irregular plaque surface and plaque at the anterior wall were also significantly higher than those of asymptomatic group(P<0.05).Logistic regression analysis results revealed that lumen positive remodeling,irregular plaque surface and plaque at the anterior wall were the independent risk factors affecting middle cerebral artery stenosis of symptomatic atherosclerosis.Conclusion 3D T_(1)-SPACE high-resolution magnetic resonance vessel wall imaging can be used to effectively assess the characteristics of arterial plaques in patients with cerebrovascular diseases.The middle cerebral artery stenosis of symptomatic atherosclerosis is usually accompanied by lumen positive remodeling,irregular plaque surface and plaque at the anterior wall,having a guiding significance for predicting the risk and classification of cerebrovascular accidents in patients.