目的研究基底动脉重构模式与斑块特征的关系以及与急性脑梗死的相关性。方法回顾性分析2018年6月~2021年8月在3.0 T MRI扫描仪行高分辨率磁共振成像(HR-MRI),诊断为基底动脉狭窄的86例患者临床和影像学资料,其中梗死组39例,非梗死组47例...目的研究基底动脉重构模式与斑块特征的关系以及与急性脑梗死的相关性。方法回顾性分析2018年6月~2021年8月在3.0 T MRI扫描仪行高分辨率磁共振成像(HR-MRI),诊断为基底动脉狭窄的86例患者临床和影像学资料,其中梗死组39例,非梗死组47例,正性重构组(PR)组40例(51.16%),非正性重构组(Non-PR)组46例(48.83%)。比较梗死组与非梗死组、PR组与Non-PR组基底动脉管壁狭窄的平扫T1WI VISTA、增强后T1WI VISTA,并分析重构模式与急性脑梗死之间的关系。结果梗死组正性重构(61.70%比21.27%,P<0.001)、斑块内出血(IPH)(41.03%比4.26%,P<0.001)、明显强化(58.97%比17.02%,P<0.001)、斑块大小(7.07±3.44比5.01±3.91,P<0.001),斑块负荷(28.72±10.99比20.96±14.33,P=0.007)等指标均明显高于非梗死组。PR组斑块内出血(37.50%比6.52%,P<0.001)、明显强化(52.50%比21.74%,P<0.001)高于Non-PR组(P<0.001)、斑块大小(8.24±2.60比3.95±3.61,P<0.001)、斑块负荷(32.46±8.86比17.54±12.90,P<0.001)高于Non-PR组(P<0.001)。多变量分析结果显示,斑块内出血是急性脑梗死的最强独立斑块特征[优势比(95.00%置信区间):18.408(2.758,122.871);P=0.003]。斑块明显强化与急性脑梗死相关[优势比:8.459(2.321,30.831);P=0.001]。正性重构也与急性脑梗死相关[优势比:5.761(1.362,24.366);P=0.017]。正性重构诊断急性脑梗死的敏感度74.4%,特异度76.6%,ROC曲线下面积为0.755。结论正性重构较非正性重构管壁出现更多的斑块明显强化和IPH,管壁正性重构与急性脑梗死相关。展开更多
Background Cerebral microbleeds （CMBs） occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The ob...Background Cerebral microbleeds （CMBs） occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The objective of this study was to assess the prevalence, distribution, severity and associated clinical features of CMBs in a prospective hospital patient based cohort undergoing brain MRI for suspected cerebrovascular disease, excluding cases with known intracranial hemorrhage or prior large-area stroke. Methods The study population consisted of 447 patients who were evaluated with T2＊-gradient echo sequences to detect the CMBs lesion number, location, and their association with white matter hyperintensities and clinical parameters, including blood pressure. Results CMB lesions were presented in 95 of the 447 patients （21.3%）. The distribution of CMBs was 43.95% cortical, 19.77% thalamic, 14.41% in the brainstem, 11.58% cerebellar, 6.21% periventricular white matter, 5.64% involving the basal ganglia regions, and 0.28% involving the hippocampus. There was a statistically significant association between the presence of CMBs and advancing age （adjusted OR 2.082, P 〈0.01）, the severity of hypertension （adjusted OR 2.208 P 〈0.01）. Also there was a statistically significant （P 〈0.01） correlation between the presence of CMBs and the severity of hypertension and white matter lesions. Conclusions CMBs occur frequently in patients with no prior large-area stroke who were referred for brain MRI for suspected cerebrovascular disease. The severity of CMBs correlates with the severity of hypertension and the presence of cerebral white matter changes detected by MRI.展开更多
文摘目的研究基底动脉重构模式与斑块特征的关系以及与急性脑梗死的相关性。方法回顾性分析2018年6月~2021年8月在3.0 T MRI扫描仪行高分辨率磁共振成像(HR-MRI),诊断为基底动脉狭窄的86例患者临床和影像学资料,其中梗死组39例,非梗死组47例,正性重构组(PR)组40例(51.16%),非正性重构组(Non-PR)组46例(48.83%)。比较梗死组与非梗死组、PR组与Non-PR组基底动脉管壁狭窄的平扫T1WI VISTA、增强后T1WI VISTA,并分析重构模式与急性脑梗死之间的关系。结果梗死组正性重构(61.70%比21.27%,P<0.001)、斑块内出血(IPH)(41.03%比4.26%,P<0.001)、明显强化(58.97%比17.02%,P<0.001)、斑块大小(7.07±3.44比5.01±3.91,P<0.001),斑块负荷(28.72±10.99比20.96±14.33,P=0.007)等指标均明显高于非梗死组。PR组斑块内出血(37.50%比6.52%,P<0.001)、明显强化(52.50%比21.74%,P<0.001)高于Non-PR组(P<0.001)、斑块大小(8.24±2.60比3.95±3.61,P<0.001)、斑块负荷(32.46±8.86比17.54±12.90,P<0.001)高于Non-PR组(P<0.001)。多变量分析结果显示,斑块内出血是急性脑梗死的最强独立斑块特征[优势比(95.00%置信区间):18.408(2.758,122.871);P=0.003]。斑块明显强化与急性脑梗死相关[优势比:8.459(2.321,30.831);P=0.001]。正性重构也与急性脑梗死相关[优势比:5.761(1.362,24.366);P=0.017]。正性重构诊断急性脑梗死的敏感度74.4%,特异度76.6%,ROC曲线下面积为0.755。结论正性重构较非正性重构管壁出现更多的斑块明显强化和IPH,管壁正性重构与急性脑梗死相关。
文摘Background Cerebral microbleeds （CMBs） occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The objective of this study was to assess the prevalence, distribution, severity and associated clinical features of CMBs in a prospective hospital patient based cohort undergoing brain MRI for suspected cerebrovascular disease, excluding cases with known intracranial hemorrhage or prior large-area stroke. Methods The study population consisted of 447 patients who were evaluated with T2＊-gradient echo sequences to detect the CMBs lesion number, location, and their association with white matter hyperintensities and clinical parameters, including blood pressure. Results CMB lesions were presented in 95 of the 447 patients （21.3%）. The distribution of CMBs was 43.95% cortical, 19.77% thalamic, 14.41% in the brainstem, 11.58% cerebellar, 6.21% periventricular white matter, 5.64% involving the basal ganglia regions, and 0.28% involving the hippocampus. There was a statistically significant association between the presence of CMBs and advancing age （adjusted OR 2.082, P 〈0.01）, the severity of hypertension （adjusted OR 2.208 P 〈0.01）. Also there was a statistically significant （P 〈0.01） correlation between the presence of CMBs and the severity of hypertension and white matter lesions. Conclusions CMBs occur frequently in patients with no prior large-area stroke who were referred for brain MRI for suspected cerebrovascular disease. The severity of CMBs correlates with the severity of hypertension and the presence of cerebral white matter changes detected by MRI.
