^(18)F-NaF摄取阳性与颈动脉斑块纤维帽破裂之间的相关性

Correlation between^(18)F-NaF uptake and fibrous cap rupture in carotid plaque

目的探究斑块的^(18)F-NaF摄取与斑块的纤维帽破裂(FCR)间的相关性,以及^(18)F-NaF摄取阳性与FCR是否存在相关性。方法选取我院神经外科在1年内收治的确诊颈动脉分叉处粥样硬化的患者共31例,行高分辨磁共振血管壁成像检查(HRVWI)并用MR-VPD软件对斑块FCR情况进行分析,并于检查后1周内行^(18)F-NaF PET/CT检查。根据^(18)F-NaF在颈动脉的摄取程度,将患者分为^(18)F-NaF摄取阳性组和^(18)F-NaF摄取阴性组,分析组间斑块FCR的差异。结果31例患者中,双侧颈动脉分叉处均有斑块的患者为23例,其余8例为单侧颈动脉斑块,共收集54枚斑块。在54条动脉粥样硬化的颈动脉中,^(18)F-NaF显影阳性的颈动脉为33条,^(18)F-NaF显影阴性的颈动脉为21条,颈动脉显像阳性率为61.11%,阴性率为38.89%。^(18)F-NaF阳性组存在FCR的斑块数量占比为58%,^(18)F-NaF阴性组存在斑块FCR占比为19%,两组间斑块FCR情况的差异有统计学意义,^(18)F-NaF摄取阳性的斑块FCR的占比较^(18)F-NaF摄取阴性的斑块更多(t=2.034,P=0.045)。结论^(18)F-NaF摄取阳性的斑块较^(18)F-NaF摄取阴性的斑块FCR几率更大,^(18)F-NaF摄取在一定程度上反映了斑块FCR情况,进而评估斑块易损性。

Objective To investigate the correlation between^(18)F-NaF uptake of plaques and fibrous cap rupture(FCR)of plaques,and the correlation between^(18)F-NaF uptake positivity and FCR.Methods Thirty-one patients with confirmed atherosclerosis at the carotid bifurcation who were admitted to our hospital within a year of diagnosis were selected.The patients underwent high-resolution magnetic resonance vessel wall imaging with MR-VPD software.The plaque FCR conditions was analyzed.The^(18)F-NaF PET/CT was performed with in 1 week after high-resolution magnetic resonance vessel wall imaging examination.Based on the extent of^(18)F-NaF uptake in carotid arteries,patients were divided into^(18)F-NaF uptake positive and^(18)F-NaF uptake negative groups.Differences of plaque FCR between groups were analyzed.Results There were 23 patients with both plaques in bilateral carotid bifurcations out of 31 patients and the remaining 8 patients with unilateral carotid plaques were included in this study.Fifty-four plaques were collected.Among 54 atherosclerotic carotid arteries,33 carotid arteries were positive by^(18)F-NaF imaging and 21 carotid arteries were negative by^(18)F-NaF imaging,showing 61.11%positive and 38.89%negative carotid artery images.The proportion of plaques with FCR present was 58%in the^(18)F-NaF positive group and 19%in the^(18)F-NaF negative group.The difference in the FCR situation of plaques between the two groups was statistically significant,with a higher proportion of plaques positive for^(18)F-NaF uptake having FCR than plaques negative for^(18)F-NaF uptake.(t=2.034,P=0.045).Conclusion Plaques positive for^(18)F-NaF uptake has greater odds of FCR than plaques negative for^(18)F-NaF uptake.^(18)F-NaF uptake to some extent reflects plaques with FCR,which in turn assesses plaque vulnerability.