高分辨率MRI成像在评估缺血预适应后颈部血管斑块变化的应用

Application of high-resolution MRI imaging in assessing the changes of cervical vascular plaques after ischemic preconditioning

目的 探讨高分辨率MRI(HR-MRI)成像在评估缺血性卒中患者缺血预适应后颈部血管斑块变化的应用价值。方法 选取于2023年1月-2023年9月江苏省第二中医院收治的颈动脉相关的缺血性脑卒中120例患者,作为研究对象。所有患者均进行3.0 T MR常规卒中方案扫描及斑块HR-MRI检查。根据卒中症状发生至HR-MRI检查间隔,将患者分为早期组(间隔<4周)、中期组(间隔为4~12周)、晚期组(间隔>12周)各40例。分析患侧颈动脉血管的管壁特征(管腔狭窄程度、最小管腔面积)及斑块变化(斑块内成分、斑块负荷、斑块强化率、T1WI及T2WI斑块信号强度指数)。比较3组间管壁特征及斑块变化的差别,分析症状发生后时间与斑块变化(斑块内成分、斑块负荷、斑块强化率、T1WI及T2WI斑块信号强度指数)之间的关系。结果 3组患者的管腔狭窄程度与最小管腔面积比较差异有统计学意义(P<0.05)。3组患者的斑块内成分比较,差异有统计学意义(P<0.05)。症状发生后时间与斑块内成分(纤维脂质核心面积、钙化面积、出血面积)、斑块负荷、斑块强化率、T1WI及T2WI斑块信号强度指数之间的相关分析显示,症状发生后时间与上述指标呈负相关(r值分别为-0.731、-0.621、-0.689、-0.732、-0.714、-0.658,均P<0.01)。结论 HR-MRI能够有效地显示缺血性卒中患者缺血预适应后颈部血管斑块的变化,对于评估卒中的发生风险和指导临床治疗具有重要的价值。

Objective To explore the diagnostic value of high-resolution MRI(HR-MRI)for cervical vascular plaques after ischemic preconditioning in patients with ischemic stroke.Methods A total of 120 patients with carotid-related ischemic stroke who were admitted to Jiangsu Second Hospital of Traditional Chinese Medicine from January 2023 to September 2023 were selected as the research subjects.All patients underwent 3.0 T MR routine stroke protocol scan and plaque high-resolution MRI(HR-MRI)examination.According to the interval between stroke onset and HR-MRI examination,they were divided into three groups(n=40):an early group(interval<4 weeks),a middle group(interval 4-12 weeks),and a late group(interval>12 weeks).The wall characteristics(luminal stenosis degree and minimum luminal area)and plaque changes(plaque components,plaque burden,plaque enhancement rate,T1WI and T2WI plaque signal intensity indexes)of the affected carotid artery were analyzed.The three groups were compared for their differences of wall characteristics and plaque changes.The relationships between time after onset and plaque changes(plaque components,plaque burden,plaque enhancement rate,T1WI and T2WI plaque signal intensity indexes)were analyzed.Results There were statistical differences,lumen stenosis degree and minimum lumen area,among the three groups(P<0.05).The plaque composition among the three groups of patients was also statistically different(P<0.05).The correlation analysis between time after onset and plaque components(fibrous lipid core area,calcification area,and hemorrhage area),plaque burden,plaque enhancement rate,T1WI and T2WI plaque signal intensity indexes showed that time after onset was negatively correlated with these indicators(r values were-0.731,-0.621,-0.689,-0.732,-0.714,-0.658 respectively,P values were all<0.01).Conclusions HR-MRI can effectively show the changes of cervical vascular plaques after ischemic preconditioning in patients with ischemic stroke,which has important value for assessing the risk of stroke and guiding clinical treatment.