MR-VWI技术评价症状性颈动脉斑块易损特征的价值观察

Evaluation Value of MR-VWI for Characteristics of Plaque Vulnerability in Symptomatic Carotid Stenosis

目的探讨磁共振管壁成像(MR-VWI)技术评价症状性颈动脉斑块易损特征的应用价值。方法选取2020年7月~2022年7月在我院神经内科收治的够例症状性颈动脉狭窄患者作为研究对象,并在入组后完成双侧颈动脉MR-VWI检查。对入组对象进行颈动脉狭窄分级,比较不同分级患者斑块易损特征,相关性分析颈动脉斑块易损特征与卒中量表神经功能(NIHSS)评分的关系;比较症状侧与非症状侧斑块负荷水平[最小管腔面积(Min LA)、平均管壁面积(Mean WA)、最大管壁厚度(Max WT)、管壁体积标准化指数(PWV)、不同斑块成分[富脂质核(LRNC)、出血(IPH)、钙化(CA)、纤维帽(FCR)]及其大小差异。结果轻度、中度和重度颈动脉狭窄患者分别有32例、37例和29例。随着颈动脉狭窄分级增高,Min LA水平不断降低,Max WT、PWV水平和NIHSS评分不断升高;CA、LRNC、IPH、FCR发生率逐渐增加(P<0.05)。Pearson相关性分析显示,NIH SS评分与Min LA呈负相关(r=-0.704),与Max WT、PWV呈正相关(r=0.719、0.565)。症状侧Min LA水平低于非症状侧,Mean WA水平、Max WT水平、PWV水平均高于非症状侧(P<0.05)。症状侧CA、FCR发生率高于非症状侧,差异均有统计学意义(P<0.05);症状侧LRNC、IPH、CA水平均高于非症状侧,差异均有统计学意义(P<0.05)。结论MR-VWI技术对症状性颈动脉斑块易损特征有良好的应用价值,可以评估动脉狭窄斑块患者斑块特征和血管壁情况。

Objective To explore the evaluation value of magnetic resonance vessel wall imaging(MRVWI)for characteristics of plaque vulnerability in symptomatic carotid stenosis.Methods A total of 98 patients with symptomatic carotid stenosis admitted to Neurology Department of the hospital were enrolled as the research objects between July 2020 and July 2022.All underwent MR-VWI examination of bilateral carotid artery after enrollment.The characteristics of plaque vulnerability in patients with different grading of carotid stenosis were compared.The relationship between characteristics of plaque vulnerability and score of National Institutes of Health Stroke Scale(NIH SS)was analyzed by correlation analysis.The differences in plaque load[minimum lumen area(Min LA),mean wall area(Mean WA),maximum wall thickness(Max WT),percent wall volume(PWV)],different plaque components[lipid-rich necrotic core(LRNC),intraplaque hemorrhage(IPH),calcification(CA),fibrous cap(FCR)]and plaque size in symptomatic and asymptomatic sides were compared.Results In the 98 patients,there were 32 cases,37 cases and 29 cases with mild,moderate and severe carotid stenosis,respectively.With the increase of carotid stenosis grading,Min LA level was decreased,Max WT,PWV and NIHSS score were increased.The incidence of CA,LRNC,IPH and FCR was increased(P<0.05).Pearson correlation analysis showed that Min LA level was negatively correlated with NIH SS score(r=-0.704),while Max WT and PWV were positively correlated with it(r=0.719,0.565).Min LA level in symptomatic side was lower than that in non-symptomatic side,while Mean WA,Max WT and PWV were higher than those in non-symptomatic side(P<0.05).The incidence of CA and FCR in symptomatic side was higher than that in non-symptomatic side(P<0.05),LRNC,IPH and CA were higher than those in non-symptomatic side(P<0.05).Conclusion MR-VWI has good application value in characteristics of plaque vulnerability in symptomatic carotid stenosis,which can evaluate plaque characteristics and vascular wall conditions in patients with carotid stenosis.