迂曲的基底动脉粥样硬化斑块纵轴分布特点

Longitudinal distribution characteristics of atherosclerotic plaques in the tortuous basilar artery

目的采用高分辨MRI分析迂曲的基底动脉斑块的纵轴分布特征,为预测后循环缺血性脑卒中的发生提供帮助。方法回顾性分析我院神经内科住院并接受高分辨MRI检查的患者60例,基底动脉检测到斑块共90个。依据斑块与迂曲弧顶的关系,将所有患者分为:分叉组(n=19)、近端组(n=43)和远端组(n=28),比较3组患者的一般资料、管壁及斑块特点。将近端组及远端组患者依据迂曲方向分为右迂曲组(n=52)和左迂曲组(n=19),比较基底动脉斑块分布与迂曲方向的关系。结果60例患者的斑块最常位于近端组。近端组血管面积大于远端组(P=0.049),近端组管壁面积大于远端组(P=0.010)。3组患者斑块分布的差异有统计学意义(P=0.001),弧顶近端及远端斑块多位于侧壁,分叉处斑块多位于前壁。对于近端组和远端组,左侧壁斑块更常分布在右侧迂曲的患者(10.5%vs 42.3%,P=0.012);右侧壁斑块更常分布在左侧迂曲的患者(25.0%vs 57.9%,P=0.009)。结论迂曲的基底动脉斑块最常位于弧顶近端,基底动脉迂曲弧顶周围的斑块多位于侧壁及迂曲弧内壁。

Objective To analyze the longitudinal distribution characteristics of atherosclerotic plaques in the tortuous basilar artery using high-resolution magnetic resonance imaging,for predicting the occurrence of posterior circulation ischemic stroke.Methods We involved the retrospective analysis of 60 patients who underwent high-resolution magnetic resonance imaging exams at our hospital's neurology department,and 90 plaques were detected.All patients were divided into three groups based on the relationship between the plaque's location and the tortuous arc top:bifurcation(n=19),proximal(n=43)and distal(n=28).The characteristics of the vessel wall,plaque,and general data were compared between the three groups.All patients in the proximal group and the distal group were divided into the right tortuosity group(n=52)and the left tortuosity group(n=19)based on the direction of basilar artery convexity.The relationship between the distribution of plaque and the direction of basilar artery convexity was compared.Results Among 60 patients,plaques were mostly located in the proximal group.The vessel area in the proximal group was larger than that in the distal group(P=0.049),and the vessel wall area in the proximal group was larger than that in the distal group(P=0.010).There was a statistically significant difference in the distribution of plaques among the three groups(P=0.001).The plaques at the proximal and the distal groups were mostly located in the lateral wall,and the plaques at the bifurcation group were mostly located in the anterior wall.For both the proximal and the distal groups,the plaque distribution in the left wall was more frequent in patients with right convex basilar artery(10.5%vs 42.3%,P=0.012),the plaque distribution in the right wall was more frequent in patients with left convex basilar arter(25.0%vs 57.9%,P=0.009).Conclusion Plaques in the tortuous basilar artery were mostly located at the proximal of the arc top,and plaques at the arc top's proximal and distal ends were mostly located in the tortuous arc's lateral and inner walls.