颅内动脉狭窄斑块高分辨磁共振成像特征及斑块强化患者临床特征分析

High-resolution magnetic resonance imaging characteristics of intracranial arterial stenosis plaque and clinical analysis of plaque enhancement

目的分析颅内动脉狭窄斑块高分辨磁共振成像(HR-MRI)特征及斑块强化患者临床特征。方法回顾性分析2019年6月至2021年2月本院收治的86例缺血性脑卒中患者的临床资料,均接受HR-MRI检查,按照以强化程度≥垂体柄强化分为非明显强化组(n=32)与明显强化组(n=54)。分析动脉斑块检出情况,比较非责任动脉斑块与责任动脉斑块HR-MRI特征及非明显强化组与明显强化组的临床特征。结果86例缺血性脑卒中患者中,共检出323块动脉斑块,其中非责任动脉斑块214块,责任动脉斑块109块。责任动脉斑块的管腔狭窄程度<50%、非明显强化、脑前动脉与后动脉斑块比例均低于非责任动脉斑块,最小管腔面积小于非责任动脉斑块,差异有统计学意义(P<0.05)。明显强化组与非明显强化组体重指数(BMI)和总胆固醇(TC)、三酰甘油(TG)、和高密度脂蛋白胆固醇(HDL-C)水平及高血压史、糖尿病史、吸烟史比例比较差异无统计学意义;明显强化组冠心病史比例、低密度脂蛋白胆固醇(LDL-C)水平、LDL-C/HDL-C均高于非明显强化组,差异有统计学意义(P<0.05)。结论冠心病史及LDL-C水平、LDL-C/HDL-C升高是颅内动脉狭窄斑块强化患者的临床特征,HR-MRI可显示颅内动脉狭窄斑块特征、强化程度,反映颅内动脉狭窄斑块的稳定性。

Objective To analyze the high-resolution magnetic resonance imaging(HR-MRI)characteristics of intracranial arterial stenosis plaques and the clinical characteristics of patients with plaque enhancement.Methods The clinical data of 86 patients with ischemic stroke admitted to our hospital from June 2019 to February 2021 were retrospectively analyzed,all of them received HR-MRI detection,and they were divided into the non-obvious reinforcement group(n=32)and the obvious reinforcement group(n=54)according to the reinforcement degree≥pituitary stem reinforcement.The detection of arterial plaque was analyzed,and the HR-MRI characteristics of the non-responsible arterial plaque and the responsible arterial plaque were compared,and the clinical characteristics between the non-obvious reinforcement group and the obvious reinforcement group were compared.Results A total of 323 arterial plaques were detected in 86 patients with ischemic stroke,including 214 plaques in non-responsible arteries,and 109 plaques in responsible arteries.The proportion of the degree of luminal stenosis<50%,non-obvious enhancement,anterior and posterior cerebral artery plaque in the responsible artery plaque were lower than those in the non-responsible artery plaque,and the minimum lumen area was smaller than that in the non-responsible artery plaque,and the differences were statistically significant(P<0.05).There was no significant difference in body mass index(BMI),levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and the proportion of history of hypertension,diabetes and smoking between the obvious reinforcement group and the non-obvious reinforcement group.The proportion of the history of coronary heart disease,low-density lipoprotein cholesterol(LDL-C)level and LDL-C/HDL-C ratio in the obvious reinforcement group were higher than those in the obvious non-reinforcement group,and the levels of LDL-C and LDL-C/HDL-C were lower than those in the nonobvious reinforcement group,and the differences were statistically significant(P<0.05).Conclusion History of coronary heart disease and the increased of LDL-C level,LDL-C/HDL-C are the clinical characteristics of patients with enhanced plaque of intracranial artery stenosis,HR-MRI can show the characteristics and enhancement degree of intracranial artery stenosis plaque,and reflect the stability of intracranial artery stenosis plaque.