High-resolution magnetic resonance vessel wall imaging can evaluate recurrence of cerebral infarction tiggered by carotid plaques
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摘要:
目的 探究高分辨磁共振血管壁成像对颈动脉斑块引发脑梗死再发的评估价值。 方法 选取我院2021年6月~2022年6月收治的脑梗死再发患者作为研究组(n=60), 另选取初发脑梗死患者作为对照组(n=60)。两组研究对象均进行高分辨磁共振血管壁成像检查, 比较两组研究对象临床特征资料、颈动脉斑块负荷、颈动脉斑块成分、颈动脉斑块成分面积。 结果 研究组的管腔面积高于对照组(P < 0.05), 血管总面积值和管壁标准化指数均高于对照组(P < 0.05), 但管壁面积值和管腔狭窄率的差异无统计学意义(P > 0.05)。研究组钙化、脂质坏死核心、斑块内出血和纤维帽破裂占斑块成分的比例高于对照组(P < 0.05), 但斑块内钙化及管腔狭窄率 > 50%的比例的差异无统计学意义(P > 0.05)。研究组患者的脂质坏死核心面积、斑块内钙化面积及斑块内出血面积均大于对照组(P < 0.001)。 结论 高分辨磁共振血管壁成像不仅能显示血管壁的狭窄程度, 同时可以有效显示颈动脉斑块的成分及面积, 对颈动脉斑块引发的脑梗死预防提供可靠依据, 有效降低脑梗死的再发率。 -
关键词:
- 高分辨磁共振血管壁成像 /
- 脑梗死 /
- 动脉斑块 /
- 评估价值 /
- 管腔狭窄
Abstract:Objective To evaluate the value of high-resolution magnetic resonance vessel wall imaging for recurrence of cerebral infarction triggered by carotid plaques. Methods Patients with recurrent cerebral infarction and patients with initial cerebral infraction in our hospital from June 2021 to June 2022 were enrolled as study group (n=60) and control group (n=60).All patients received high-resolution magnetic resonance vessel wall imaging.Then comparison was conducted on the clinical characteristics, carotid plaque burden and compositional features. Results Study group had notably increased luminal area and larger total vessel area and vessel wall normalization index than control group (P < 0.05), while no statistical difference was found in vessel wall area and luminal stenosis rate between two groups (P > 0.05).The proportions of carotid plaques of calcification, lipoid-rich necrotic core, intraplaque hemorrhage and fibrous cap rupture were higher in study group than in control group (P < 0.05), while the proportion of intraplaque calcification and luminal stenosis > 50% demonstrated no statistical difference between two groups (P > 0.05).The area of lipoid-rich necrotic core, intraplaque calcification and intraplaque hemorrhage were significantly larger in study group than in control group (P < 0.001). Conclusion Application of high-resolution magnetic resonance vessel wall imaging can effectively display the stenosis degree of the vessel wall, carotid plaque burden and compositional features.It provide a basis for the prevention of cerebral infarction triggered by carotid plaques, thus effectively reducing the recurrence rate of cerebral infarction. -
图 1 脑梗死再发患者的HR-MRI图像
Figure 1. HR-MRI of patients with recurrent cerebral infarction. A: T1WI enhanced imaging; B: T1WI imaging; C: PDWI proton imaging; D: Brain T2 FLAIR imaging.
表 1 两组研究对象颈动脉斑块负荷比较
Table 1. Comparison of carotid plaque load between the two groups (n=60, Mean±SD)
Group LA（mm2） WA（mm2） TVA（mm2） NWI（mm2） Luminal stenosis rate（%） Study group 31.84±10.86 72.63±20.41 113.09±31.22 72.23±18.76 52.75±15.68 Control group 40.57±12.32 70.87±19.54 101.47±29.65 60.85±16.34 48.33±15.31 t 4.1175 0.4825 2.0905 3.5432 1.5623 P 0.0001 0.6304 0.0387 0.0006 0.1209 LA: Luminal area; WA: Vessel wall area; TVA: Total vessel area; NWI: Vessel wall normalization index. 
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表 2 两组颈动脉斑块成分及管腔狭窄率比较
Table 2. Comparison of carotid plaque components and lumen stenosis rate between the two groups [n=60, n(%)]
Group LRNC Intraplaque calcification IPH Fibrous cap rupture Luminal stenosis > 50% Study group 42（70.00） 31（51.67） 25（41.67） 21（35.00） 30（50.00） Control group 29（48.33） 28（46.67） 9（15.00） 3（5.00） 27（45.00） χ2 5.8293 0.3001 10.5062 16.8750 0.3008 P 0.0158 0.5838 0.0012 < 0.001 0.5834 LRNC: Lipoid-rich necrotic core; IPH: Intraplaque hemorrhage.
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表 3 两组颈动脉斑块成分面积比较
Table 3. Comparison of carotid plaque component area between the two groups (n=60, Mean±SD)
Group LRNC（mm2） Intraplaque calcification（mm2） IPH（mm2） Study group 25.41±6.43 3.86±1.14 12.33±3.29 Control group 3.57±0.88 1.57±0.42 0.42±0.09 t 26.0668 14.6005 28.0304 P < 0.001 < 0.001 < 0.001
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