PETRA-MRA imaging of stenosis degree and prognosis in patients with atherosclerotic middle cerebral artery stenosis
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摘要:
目的 分析大脑中动脉粥样硬化性狭窄患者狭窄程度及预后的径向采集逐点编码缩短时间MR血管成像(PETRA-MRA)影像的相关性。 方法 本研究采取回顾性研究，以2021年5月~2022年6月本院收治的72例大脑中动脉粥样硬化性狭窄患者作为研究对象，根据Rankin量表(mRS)评分(以mRS评分 > 2分为预后不良)将患者分为预后不良组(n=15)和预后良好组(n=57)。比较不同狭窄程度、不同预后患者的大脑中动脉血流信号评分、磁敏感伪影评分之间的差异。 结果 针对大脑中动脉硬化患者的诊断而言，时间飞跃法MR血管成像(TOF-MRA)诊断对患者的病灶部位的狭窄程度以及病变程度高于PETRA-MRA，差异有统计学意义(P < 0.05);TOF-MRA诊断对患者的病灶部位的磁敏感伪影评分以及血流信号评分高于PETRA-MRA，差异有统计学意义(P < 0.05);不同狭窄程度患者的病灶部位的长度以及狭窄程度之间的差异有统计学意义(P < 0.05);不同狭窄程度患者的病灶部位的磁敏感伪影评分以及血流信号评分的差异无统计学意义(P > 0.05);预后良好组患者的病灶部位的长度以及狭窄程度低于对照组，差异有统计学意义(P < 0.05);不同预后患者的病灶部位磁敏感伪影评分以及血流信号评分的差异无统计学意义(P > 0.05)。 结论 采用PETRA-MRA对大脑中动脉粥样硬化性狭窄患者狭窄程度及预后进行评估，其图像质量较好，建议临床推广。 -
关键词:
- 大脑中动脉粥样硬化 /
- PETRA-MRA /
- 预后 /
- 大脑中动脉血流信号评分 /
- 磁敏感
Abstract:Objective To study the correlation between stenosis degree and prognosis in patients with middle cerebral artery stenosis by PETRA-MRA imaging. Methods Seventy-five patients with middle cerebral artery atherosclerotic stenosis admitted to our hospital from May 2021 to June 2022 were selected as the subjects. According to the Rankin Scale (mRS score > 2 indicates poor prognosis), the patients were divided into poor prognosis group (n=15) and good prognosis group (n=57). The differences of MCA blood flow signal score and magnetic sensitivity pseudo- film score in patients with different stenosis degree and prognosis were compared. Results For the diagnosis of middle cerebral artery sclerosis patients, the degree of stenosis and lesion in the lesion site of patients diagnosed by TOF-MRA was significantly higher than that by PETRA-MRA (P < 0.05). The scores of magnetic sensitivity pseudo-film and blood flow signal of the lesions of patients diagnosed by TOF-MRA were higher than those of PETRA-MRA (P < 0.05). There were statistically significant differences in the length of lesion site and the degree of stenosis among patients with different degrees of stenosis (P < 0.05). There was no statistical significance in the magnetic sensitivity pseudo-film scores and blood flow signal scores of patients with different stenosis degrees (P > 0.05). The length of lesion site and stenosis degree in patients with good prognosis group were significantly lower than those in control group (P < 0.05). There was no statistical significance in the magnetic sensitivity pseudo-film scores and blood flow signal scores of patients with different prognosis (P > 0.05). Conclusion The image quality of PETRA-MRA is good to evaluate the stenosis degree and prognosis of patients with middle cerebral artery atherosclerotic stenosis. -
图 1 不同狭窄程度患者的病灶部位的长度以及狭窄程度比较
A: Ⅰ型狭窄; B: Ⅱ型狭窄; C: Ⅲ型狭窄.
Figure 1. Comparison of the length of the lesion site and the degree of stenosis in patients with different degrees of stenosis.
表 1 两种诊断方法对病灶部位的狭窄程度以及病变程度的诊断结果比较
Table 1. Comparison of the diagnostic results of the two diagnostic methods on the degree of stenosis at the lesion site and the degree of lesion (n=72, Mean±SD)
诊断方法 狭窄程度(%) 病变程度(mm) TOF-MRA 59.22±2.41 15.12±2.12 PETRA-MRA 46.63±2.52 12.34±1.97 t 30.637 8.151 P < 0.001 < 0.001 TOF-MRA: 时间飞跃法MR血管成像; PETRA-MRA: 径向采集逐点编码缩短时间MR血管成像. 
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表 2 两种诊断方法对病灶部位的图像质量比较
Table 2. Comparison of image quality between the two diagnostic methods on the lesion site (Score, n=72, Mean±SD)
诊断方法 磁敏感伪影评分 血流信号评分 TOF-MRA 2.93±0.61 2.54±0.28 PETRA-MRA 1.49±0.48 1.22±0.34 t 15.742 25.430 P < 0.001 < 0.001
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表 3 不同狭窄程度患者的病灶部位的长度以及狭窄程度比较
Table 3. Comparison of the length of the lesion site and the degree of stenosis in patients with different stenosis degrees (Mean±SD)
狭窄程度分型 狭窄程度(%) 病变程度(mm) Ⅰ型(n=35) 37.52±2.84 10.82±1.68 Ⅱ型(n=21) 47.05±2.78 12.03±1.77 Ⅲ型(n=16) 49.12±1.81 14.21±2.32 F 13.251 14.112 P < 0.001 < 0.001
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表 4 不同狭窄程度患者的磁敏感伪影评分以及血流信号评分比较
Table 4. Comparison of magnetic sensitivity pseudo- film scores and blood flow signal scores of patients with different stenosis degrees (score, Mean±SD)
狭窄程度分型 磁敏感伪影评分 血流信号评分 Ⅰ型(n=35) 1.47±0.32 1.25±0.55 Ⅱ型(n=21) 1.49±0.26 1.23±0.99 Ⅲ型(n=16) 1.52±0.55 1.20±0.73 F 0.858 0.887 P 0.123 0.099
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表 5 不同预后患者的病灶部位的长度以及狭窄程度比较
Table 5. Comparison of the length of the lesion site and the degree of stenosis in patients with different prognosis (Mean±SD)
组别 狭窄程度(%) 病变程度(mm) 预后良好组(n=57) 35.17±2.89 16.38±1.72 预后不良组(n=15) 52.52±2.38 11.52±2.21 t 23.965 7.910 P < 0.001 < 0.001
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表 6 不同预后患者的病灶部位图像质量比较
Table 6. Comparison of image quality of lesion sites in patients with different prognosis (score, Mean±SD)
组别 磁敏感伪影评分 血流信号评分 预后良好组(n=57) 1.47±0.37 1.21±0.25 预后不良组(n=15) 1.49±1.51 1.20±0.36 t 0.051 0.101 P 0.960 0.920
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