颅内管腔非狭窄性脑卒中患者动脉粥样硬化斑块特点

Characteristics of atherosclerotic plaque in patients with intracranial non-stenosis stroke

目的以高分辨率MRI(HRMRI)观察颅内管腔非狭窄性脑卒中患者动脉粥样硬化斑块的特点。方法纳入41例MR血管造影(MRA)未见明显异常的动脉粥样硬化性缺血性脑卒中患者,根据HRMRI所见分析其颅内动脉粥样斑块,比较责任斑块与非责任斑块位置、强化、血管重构及斑块负荷的差异。结果41例中,于33例(33/41,80.49%)中检出50个颅内斑块,平均负荷值(12.96±8.03)%;斑块所在血管正性重构率72.00%(36/50)。8例(8/41,19.51%)未见明确斑块。50个斑块中,17个为责任斑块,33个为非责任斑块,责任斑块位于前循环的比例明显高于非责任斑块(P<0.05),其强化状态、负荷及血管重构差异均无明显统计学意义(P均>0.05)。结论颅内管腔非狭窄性脑卒中患者斑块负荷较低,且斑块所在血管易发生正性重构,前循环斑块更多导致脑血管病事件。

Objective To observe the characteristics of atherosclerotic on high-resolution MRI(HRMRI)in intracranial non-stenotic stroke patients.Methods A total of 41 patients with atherosclerotic ischemic stroke without obvious abnormality in MR angiography(MRA)were included.Intracranial atherosclerotic plaques were analyzed according to HRMRI,and the location,enhancement,vascular remodeling and plaque burden were compared between culprit and non-culprit plaques.Results Among 41 patients,totally 50 intracranial plaques were found in 33 cases(33/41,80.49%),with an average burden value of(12.96±8.03)%,whereas no definite plaque was found in the other 8 cases(8/41,19.51%).The positive remodeling rate was 72.00%(36/50).There were 17 culprit plaques and 33 non-culprit plaques.The proportion of culprit plaques in anterior circulation was significantly higher than that in non-culprit plaques(P<0.05),but there was no significant difference of enhancement,burden nor vascular remodeling between culprit and non-culprit plaques(all P>0.05).Conclusion Patients with intracranial non-stenotic stroke had relatively low plaque burden.Positive remodeling were likely to happened on the blood vessels where the plaques located,and the plaques in the anterior circulation were likely to induce cerebrovascular events.