基底动脉斑块分布的T1W-3D-VISTA序列诊断研究

T1W-3D-VISTA sequence diagnosis study of basilar artery plaque distribution

目的应用磁共振高分辨序列(T1W-3D-VISTA)研究基底动脉(basilar artery, BA)动脉粥样硬化斑块的分布及临床意义。方法对57例BA硬化性脑梗塞患者T1W-3D-VISTA图像及临床资料进行回顾性分析。患者分为有症状和无症状2组,有症状组22例,无症状组35例,将斑块基于BA壁的腹、背及侧壁分类,其中致病性斑块定义为供血区、相邻层面或存在可能因果关系的斑块。分析斑块分布和临床特点。结果斑块总体分布情况为腹壁30.3%、背侧壁36.5%和侧壁33.2%,分布情况相似。与无症状组相比,有症状组斑块在腹壁(15.8%vs. 44.8%)较少而侧壁(41.3%vs. 25.1%)较多(P为<0.001和0.016)。有症状脑桥梗塞和无症状静息性脑桥梗塞患者的致病性斑块分别为83.3%(15/18)和23.1%(3/13,P<0.001)。其余有症状与无症状小脑、枕叶和丘脑梗塞的致病性斑块间比较无明显差异(P>0.05)。结论 T1W-3D-VISTA序列可检测BA斑块的分布。BA动脉侧壁斑块更易引起症状性脑梗塞。

Objective To study the distribution of basilar artery(BA) atherosclerotic plaques by using high resolution magnetic resonance sequence(T1 W-3 D-VISTA) and its clinical significance. Methods T1 W-3 D-VISTA images and clinical data of 57 patients with BA sclerosing cerebral infarction were retrospectively analyzed. The patients were divided into two groups: symptomatic group and asymptomatic group. The plaques were classified based on the abdominal, dorsal and lateral walls of the BA wall. Pathogenic plaques were defined as blood supply areas, adjacent layers or plaques with possible causal relationship. Plaque distribution and clinical characteristics were analyzed. Results The overall distribution of plaques was abdominal(30.3%), dorsal(36.5%) and lateral walls(33.2%), and the distribution was similar. Compared with the asymptomatic group, the symptomatic group had fewer plaques on the abdominal wall(15.8% vs. 44.8%) and more sidewalls(41.3% vs. 25.1%)(P<0.001 and 0.016). The pathogenic plaques of patients with symptomatic and silent pons were 83.3%(15/18) and 23.1%(3/13, P<0.001). There was no significant difference between the other symptomatic and asymptomatic plaques of cerebellar, occipital lobe and thalamic infarction(P>0.05). Conclusion T1 W-3 D-VISTA sequence can detect the distribution of BA plaques. Plaques on the sidewall of BA are more likely to cause symptomatic cerebral infarction.