Plaque distribution, composition and related characteristics in patients with basilar artery stenosis by high-resolution MRI imaging
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摘要:
目的采用高分辨MRI成像分析有症状和无症状基底动脉狭窄患者斑块分布、成分及相关特征。 方法回顾性分析2018年3月~2021年3月我院收治的106例行高分辨MRI检查的基底动脉狭窄患者，根据是否存在后循环卒中分为症状性组（n=45）和无症状组（n=61），收集所有纳入对象影像学资料，分析两组斑块分布、成分、重构等相关特征。 结果症状性组斑块主要分布在背侧壁，无症状组斑块主要分布在腹侧壁，两组斑块分布差异存在统计学意义（P < 0.05）；症状性组合并斑块内出血、纤维帽断裂概率高于无症状组（P < 0.05）；症状性组患者最狭窄层的血管面积、管壁面积、管腔面积、最大管壁厚度、狭窄率、血管重构指数（RI）均高于无症状组（P < 0.05），两组斑块负荷差异无统计学意义（P > 0.05）；两组斑块强化等级分布存在明显差异，其中症状性组斑块2级强化率高于无症状组（P < 0.05）。 结论有症状和无症状基底动脉狭窄患者斑块分布、成分、重构等特征存在一定差异，而高分辨MRI成像能为识别斑块特征和及早干预提供可靠影像学参考。 Abstract:ObjectiveTo analyze the distribution, composition and related characteristics of plaque in patients with symptomatic and asymptomatic basilar artery stenosis using high-resolution MRI imaging. MethodsA retrospective analysis of 106 patients with basilar artery stenosis who underwent high-resolution MRI examinations in our hospital was conducted from March 2018 to March 2021. They were divided into symptomatic group (n=45) and asymptomatic group (n=61) according to the presence or absence of posterior circulation stroke with the imaging data collected. The distribution, composition, reconstruction and other related characteristics of the two groups of plaques were analyzed. ResultsThe plaques of the symptomatic group mainly localized on the dorsal wall, the plaques of the asymptomatic group mainly localized on the ventral wall, the distribution and composition of the plaques in the two groups were significantly different (P < 0.05). The probability of bleeding and fiber cap rupture in symptomatic group was higher than that in asymptomatic group (P < 0.05). The vascular area, wall area, lumen area, maximum wall thickness, stenosis rate, and vascular remodeling index of the most stenosis layer in the symptomatic group were higher than those in the asymptomatic group (P < 0.05). There was no significant difference in plaque load between the two groups (P > 0.05). There was a significant difference in the distribution of plaque enhancement grades between the two groups, and the level 2 plaque enhancement rate of the symptomatic group was higher than that of the asymptomatic group (P < 0.05). ConclusionThere are massive differences between symptomatic and asymptomatic patients with basilar artery stenosis in plaque distribution, composition, and remodeling. High-resolution MRI imaging can give a reliable imaging reference for identifying plaque characteristics and early intervention. -
Key words:
- high-resolution MRI /
- basilar artery stenosis /
- plaque distribution /
- plaque composition
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图 1 基于HR-MRI图像的基底动脉斑块分布
A: 基底动脉在图像上被分为4个象限，上下左右分别为背侧、腹侧、左侧和右侧; B: 典型症状性患者，女，47岁，HR-MRI显示斑块位于基底动脉背侧壁; C: 典型无症状性患者，男，52岁，HR-MRI显示斑块位于基底动脉腹侧壁.
Figure 1. Basilar artery plaque distribution based on HR-MRI image.
表 1 两组一般资料比较
Table 1. Comparison of general information between the two groups[n(%)]
组别 性别（男/女） 年龄（岁, Mean±SD） 合并高血压 合并高血脂 合并糖尿病 症状性组（n=45） 36/9 63.15±9.24 24（53.33） 26（57.78） 20（44.44） 无症状组（n=61） 44/17 60.23±9.78 31（50.82） 30（49.18） 27（44.26） χ2/t 0.866 0.159 0.066 0.768 0.001 P 0.352 0.824 0.798 0.381 0.985 
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表 2 两组斑块分布比较
Table 2. Comparison of plaque distribution between the two groups[n(%)]
组别 腹侧壁 背侧壁 左侧壁 右侧壁 症状性组
（n=238）36（15.13） 102（42.86） 48（20.17） 52（21.85） 无症状组
（n=272）108（39.71） 92（33.82） 27（9.93） 45（16.54） χ2 40.815 P < 0.001
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表 3 两组斑块成分特点比较
Table 3. Comparison of the characteristics of plaque composition between the two groups[n(%)]
组别 斑块内出血 纤维帽断裂 症状性组（n=238） 64（26.89） 33（13.87） 无症状组（n=272） 45（16.54） 25（9.19） χ2 4.514 2.802 P 0.034 0.045
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表 4 两组基底动脉血管面积和厚度比较
Table 4. Comparison of the area and thickness of the basilar artery between the two groups (Mean±SD)
组别 血管面积（mm2） 管壁面积（mm2） 管腔面积（mm2） 最大管壁厚度（mm2） 狭窄率(%) 斑块负荷 RI 症状性组（n=45） 24.15±3.62 21.42±3.95 4.61±1.82 2.34±0.31 62.72±14.58 -0.24±0.05 1.20±0.43 无症状组（n=61） 22.49±4.42 18.32±3.16 2.86±1.07 1.92±0.36 71.86±8.52 0.06±0.01 0.34±0.09 t 2.060 4.487 6.202 6.2909 4.051 1.209 18.302 P 0.042 < 0.001 < 0.001 < 0.001 < 0.001 0.237 < 0.001
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表 5 两组斑块强化情况比较
Table 5. Comparison of plaque enhancement between the two groups[n(%)]
组别 0级 1级 2级 症状性组（n=45） 5（11.11） 22（48.89） 18（40.00） 无症状组（n=61） 33（54.10） 16（26.23） 12（19.67） Z 20.839 P < 0.001
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