MRI扫描对脑卒中合并2型糖尿病患者颈动脉粥样硬化斑块情况的判断研究

MRI scan for the determination of carotid atherosclerotic plaques in patients with stroke and T2DM

目的:探讨磁共振成像(MRI)扫描对脑卒中合并2型糖尿病(diabetes mellitus type 2,T2DM)患者颈动脉粥样硬化斑块情况的判断。方法:选取石河子市人民医院2021年1月—2022年11月收治的120例脑卒中患者。根据患者是否合并T2DM分为对照组(脑卒中未合并T2DM患者)与研究组(脑卒中合并T2DM患者),各60例。比较两组患者颈动脉斑块MRI分型、血管总面积(total vascular area,TVA)、管壁面积(wall area,WA)和管壁标准化指数(tube wall standardization index,NWI)、颈动脉狭窄程度、纤维蛋白原(Fib)。结果:研究组患者颈动脉斑块MRI分型Ⅲ型构成比(16.67%)低于对照组(50.00%);Ⅳ~Ⅴ型(31.67%)构成比高于对照组(8.33%),Ⅵ型构成比(23.33%)高于对照组(8.33%),差异均有统计学意义(P<0.05)。研究组MRI参数TVA、WA和NWI值高于对照组,差异有统计学意义(P<0.05)。研究组颈动脉轻度狭窄率(25.00%)低于对照组(53.33%),中度狭窄率(51.67%)高于对照组(21.67%),重度狭窄率(23.33%)高于对照组(8.33%),差异均有统计学意义(P<0.05)。结论:MRI在斑块成分分析、颈动脉血管壁定量测量中的应用效果较好,适用于脑卒中合并T2DM患者颈动脉粥样硬化的患者。

Objective To investigate the determination of carotid atherosclerotic plaques by magnetic resonance imaging(MRI)scanning in patients with stroke complicated with type 2 diabetes mellitus(T2DM).Methods 120 patients with stroke admitted to the People's Hospital of Shihezi from January 2021 to November 2022 were selected retrospectively.The patients were divided into control group(stroke patients without T2DM)and study group(stroke patients with T2DM)according to whether they had T2DM,60 cases in each group.The MRI classification of carotid plaque,total vessel area(TVA),wall area(WA),wall standardization index(NWI),carotid stenosis degree and fibrinogen(FIB)were compared between the two groups.Results The composition ratio of carotid plaque MRI type III.in the study group(16.67%)was lower than that in the control group(50.00%).The composition ratio of type IV to V(31.67%)was higher than that of the control group(8.33%),and the composition ratio of type VI.(23.33%)was higher than that of the control group(8.33%),and the differences were statistically significant(P<0.05).The MRI parameters of TVA,WA and NWI in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The rate of mild carotid artery stenosis(25.00%)in the study group was lower than that of the control group(53.33%),the rate of moderate stenosis(51.67%)was higher than that of the control group(21.67%),and the rate of severe stenosis(23.33%)was higher than that of the control group(8.33%),all of which were statistically significant(P<0.05).Conclusion MRI has a good application effect in plaque composition analysis and quantitative measurement of carotid vascular wall,and is suitable for patients with carotid atherosclerosis in patients with stroke and T2DM.