急性脑梗死患者颈动脉狭窄程度与颈动脉易损斑块MRI特征关系研究

Relationship between carotid artery stenosis degree and MRI characteristics of carotid vulnerable plaque in patients with acute cerebral infarction

目的:探究急性脑梗死患者颈动脉狭窄程度与颈动脉易损斑块MRI特征的关系。方法:选择急性脑梗死患者83例为研究对象,颈动脉MRI检查后按照管腔狭窄程度分为轻度狭窄组(狭窄程度<50%,34例,98个斑块)、中度狭窄组(狭窄程度50%~70%,26例,103个斑块)和重度狭窄组(狭窄程度≥70%,23例,93个斑块)。比较三组患者颈动脉斑块性质和稳定性。分析颈动脉斑块钙化体积、富含脂质的坏死核(LRNC)体积以及斑块内出血体积(IPH)与颈动脉狭窄程度的相关性。结果:轻度狭窄组钙化斑占比最高,软斑占比最低,而重度狭窄组钙化斑占比最低,软斑占比最高,三组斑块性质比较差异有统计学意义(均P<0.05)。三组颈动脉斑块稳定性比较差异有统计学意义,且重度狭窄组不稳定斑块占比高于轻度狭窄组(均P<0.05)。随着颈动脉狭窄程度的增加,三组颈动脉斑块钙化体积、LRNC体积及IPH体积随之增加(均P<0.05)。颈动脉狭窄程度与斑块钙化体积、LRNC体积及IPH体积呈正相关(r=0.9754、0.9205、0.9868,均P<0.05)。结论:MRI对急性脑梗死患者颈动脉狭窄程度及颈动脉斑块性质均具有较好的判别价值。急性脑梗死患者颈动脉狭窄程度与颈动脉易损斑块MRI特征具有明显的相关性。

Objective:To explore the relationship between carotid artery stenosis degree and MRI characteristics of carotid vulnerable plaque in patients with acute cerebral infarction.Methods:A total of 83 patients with acute cerebral infarction were selected as the research objects.After carotid MRI examination,they were divided into mild stenosis group(stenosis degree lower than 50%,34 cases,98 plaques),moderate stenosis group(stenosis degree 50%to 70%,26 cases,103 plaques)and severe stenosis group(stenosis degree not lower than 70%,23 cases,93 plaques).The nature and stability of carotid plaque were compared among the three groups.The correlation between carotid plaque calcification volume,lipid rich necrotic core(LRNC)volume,and intraplaque hemorrhage(IPH)volume and the degree of carotid stenosis was analyzed.Results:The mild stenosis group had the highest proportion of calcified plaques and the lowest proportion of soft plaques,while the severe stenosis group had the lowest proportion of calcified plaques and the highest proportion of soft plaques,and there were significant differences among the three groups(all P<0.05).The difference of carotid plaque stability among the three groups was statistically significant,and the proportion of unstable plaque in severe stenosis group was higher than that in mild stenosis group(all P<0.05).Carotid plaque calcification volume,LRNC volume and IPH volume increased with the increase of carotid artery stenosis degree(all P<0.05).The degree of carotid stenosis was positively correlated with plaque calcification volume,LRNC volume and IPH volume(r=0.9754,0.9205,0.9868,all P<0.05).Conclusion:MRI has a good value in distinguishing the degree of carotid stenosis and the nature of carotid plaque in patients with acute cerebral infarction.The degree of carotid artery stenosis in patients with acute cerebral infarction has obvious correlation with MRI characteristics of carotid vulnerable plaques.