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1.
Feasibility of in vivo, multicontrast-weighted MR imaging of carotid atherosclerosis for multicenter studies 总被引:2,自引:0,他引:2
Chu B Zhao XQ Saam T Yarnykh VL Kerwin WS Flemming KD Huston J Insull W Morrisett JD Rand SD DeMarco KJ Polissar NL Balu N Cai J Kampschulte A Hatsukami TS Yuan C 《Journal of magnetic resonance imaging : JMRI》2005,21(6):809-817
PURPOSE: To test the image quality (ImQ) and interscan coverage of MRI for measuring carotid atherosclerosis across multiple centers. MATERIALS AND METHODS: Thirty-nine subjects from five clinical sites (site 1: n=11; site 2: n=16; site 3: n=2; site 4: n=3; site 5: n=7) were imaged on GE 1.5T scanners using a standardized carotid imaging protocol with five weightings (T1, proton density (PD), T2, time-of-flight (TOF), and contrast-enhanced (CE) T1). MR technologists from the five sites received comprehensive protocol training. A maximum coverage of 24 mm (12 slices) was designed for each of four scans (baseline and at four, eight, and 13 weeks). The adequacy of coverage was calculated as the percentage of arteries with at least six slices matched across all four scans. ImQ was evaluated using an established five-point scale for each image. ImQ>or= 3 was considered acceptable for image analysis. RESULTS: Across five sites, the mean ImQ was 3.4-4.2 for T1W, 3.6-4.4 for CE-T1W, 3.4-4.2 for PDW, 3.3-4.2 for T2W, and 3.4-4.0 for TOF. The mean ImQ per site was 3.5-4.2. All sites generated at least six-slice coverage (mean=8.0-9.1) for all index carotid arteries. CONCLUSION: The ImQ and coverage values were comparable among clinical sites using a standardized carotid imaging protocol. With comprehensive protocol training, carotid MRI is technically feasible for use in multicenter studies. 相似文献
2.
MR测定颈动脉易损斑块特征与急性缺血性脑卒中的关系 总被引:2,自引:0,他引:2
目的 分析急性缺血性脑卒中患者症状侧颈动脉粥样硬化病变特征与扩散加权成像(DWI)证实的急性脑梗死(ACI)发生及严重程度的关联性.方法 入组发生单侧肢体症状(颈内动脉供血区)的ACI患者103例,均在发病后1周内行颈动脉磁共振黑血成像(MR-BBI)及头颅常规MRI,测得症状侧颈动脉粥样硬化病变参数(管腔狭窄率、斑块负荷和成分)和相应供血区ACI病灶分布及大小,借此分析症状侧颈动脉斑块特征与ACI发生、大小的关联程度.结果 研究发现,症状侧颈动脉管壁体积标准化指数(PWV)及富脂质核(LRNC)含量是同侧供血区ACI病灶发生及大小的独立危险因素(校正管腔狭窄和临床因素前后,P<0.05).结论 ACI发生及大小与同侧供血颈动脉的斑块易损特征(高斑块负荷和大LRNC)相关联.MR-BBI能细致化评估斑块易损特征,有利于临床分层急性缺血性脑卒中的风险性及严重程度. 相似文献
3.
In vivo detection of hemorrhage in human atherosclerotic plaques with magnetic resonance imaging 总被引:3,自引:0,他引:3
Cappendijk VC Cleutjens KB Heeneman S Schurink GW Welten RJ Kessels AG van Suylen RJ Daemen MJ van Engelshoven JM Kooi ME 《Journal of magnetic resonance imaging : JMRI》2004,20(1):105-110
PURPOSE: To investigate the performance of high-resolution T1-weighted (T1w) turbo field echo (TFE) magnetic resonance imaging (MRI) for the identification of the high-risk component intraplaque hemorrhage, which is described in the literature as a troublesome component to detect. MATERIALS AND METHODS: An MRI scan was performed preoperatively on 11 patients who underwent carotid endarterectomy because of symptomatic carotid disease with a stenosis larger than 70%. A commonly used double inversion recovery (DIR) T1w turbo spin echo (TSE) served as the T1w control for the T1w TFE pulse sequence. The MR images were matched slice by slice with histology, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the MR images were calculated. Additionally, two readers, who were blinded for the histological results, independently assessed the MR slices concerning the presence of intraplaque hemorrhage. RESULTS: More than 80% of the histological proven intraplaque hemorrhage could be detected using the TFE sequence with a high interobserver agreement (Kappa = 0.73). The TFE sequence proved to be superior to the TSE sequence concerning SNR and CNR, but also in the qualitative detection of intraplaque hemorrhage. The false positive TFE results contained fibrous tissue and were all located outside the main plaque area. CONCLUSION: The present study shows that in vivo high-resolution T1w TFE MRI can identify the high-risk component intraplaque hemorrhage with a high detection rate in patients with symptomatic carotid disease. Larger clinical trials are warranted to investigate whether this technique can identify patients at risk for an ischemic attack. 相似文献
4.
Watanabe Y Nagayama M Suga T Yoshida K Yamagata S Okumura A Amoh Y Nakashita S Van Cauteren M Dodo Y 《Journal of magnetic resonance imaging : JMRI》2008,28(2):478-485
PURPOSE: To investigate whether the vessel wall MRI of carotid arteries would differentiate at-risk soft plaque from solid fibrous plaque by identifying liquid components more accurately than color Doppler ultrasonography (US). MATERIALS AND METHODS: This study included 54 carotid arteries in 54 consecutive patients who underwent carotid endarterectomy. MRI was performed using black-blood fat-suppressed (FS) T1-and FS T2-weighted TSE sequences. A total of 68 major segments of the 54 carotid plaques were grouped into four MR categories based on signal intensity index (SII). MR criteria used for the diagnosis of plaque vulnerability were: at-risk soft plaque including a segment of liquid component (category A or B), solid fibrous plaque (category C or D). The MR and US findings were compared with histopathological findings of endarterectomy specimens. RESULTS: Intraoperative findings and microscopic examination of endarterectomy specimens revealed 24 at-risk soft plaques and 30 solid fibrous plaques. The sensitivity, specificity, and accuracy for diagnosing at-risk soft plaque are 96%, 93%, and 94% for MR, and 75%, 63%, and 69% for color Doppler US, respectively. The slice-by-slice MR evaluation of carotid wall also revealed detailed information of plaque segments and correlated well with the features of corresponding histologic sections. CONCLUSION: Vessel wall MRI with MRI category could have a potential to more accurately diagnose an at-risk soft plaque predominantly composed of liquid components in comparison with color Doppler US. 相似文献
5.
目的:应用3.0T MR高分辨成像(HRMR)在体显示颈动脉粥样斑块,探讨斑块脂质成分和纤维成分的HRMR表现及其病理基础。方法:经彩超检查证实的症状性颈动脉狭窄37例,均行管壁高分辨MRI检查,检查序列包括3D TOF、DIR T1WI、T2WI及PDWI。其中22例检查前1周内行CTA检查,9例检查后1周内行颈动脉内膜剥脱术,5例接受颈动脉支架置入术。根据颈动脉内膜剥脱术斑块所在的颈动脉部位,将获得的病理标本与MRI图像逐层对照,研究斑块纤维成分和纤维帽、脂质成分和脂质坏死池的MRI表现,探讨MRI表现的病理基础。结果:37例共发现52支颈动脉存在斑块,斑块钙化21支(40.4%)、无钙化斑块31支(59.6%);31支软斑块中,纤维成分为主者8支(15.6%),有明显脂质核心斑块23支(44.2%);其中,伴斑块出血5支(10%)、脂质坏死核心3支(6%),纤维帽撕裂(溃疡或纤维帽撕裂)3支(6%)。相对于胸锁乳突肌,斑块脂质成分在TOF图像上呈等信号,T1WI呈等信号或稍高信号,PDWI多呈等信号或略高信号、少数呈低信号,T2WI上呈等信号或低信号;脂质坏死池在TOF、T1WI、PDWI和T2WI上均呈高信号;纤维帽和纤维成分的信号相仿,在TOF图像上呈等信号或低信号,T1WI上呈高信号或略高信号,PDWI呈稍高或等信号,T2WI上呈稍高信号。硬斑块纤维帽厚度(1.1±0.4)mm,软斑块纤维帽厚度(0.7±0.3)mm。硬斑块和软斑块的纤维帽厚度差异有统计学意义(P〈0.001)。结论:多序列高分辨MRI可以显示斑块脂质成分、纤维成分和纤维帽,并对斑块脂质和纤维帽进行初步的定量,为在体分析斑块的结构提供评价指标,为斑块风险性评价提供参考。 相似文献
6.
Saam T Hatsukami TS Yarnykh VL Hayes CE Underhill H Chu B Takaya N Cai J Kerwin WS Xu D Polissar NL Neradilek B Hamar WK Maki J Shaw DW Buck RJ Wyman B Yuan C 《Journal of magnetic resonance imaging : JMRI》2007,26(2):344-352
PURPOSE: To evaluate the platform and reader reproducibility of quantitative carotid plaque measurements. MATERIALS AND METHODS: A total of 32 individuals with >or=15% carotid stenosis by duplex ultrasound were each imaged once by a 1.5T General Electric (GE) whole body scanner and twice by either a 1.5T Philips scanner or a 1.5T Siemens scanner. A standardized multisequence protocol and identical phased-array carotid coils were used. Expert readers, blinded to subject information, scanner type, and time point, measured the lumen, wall, and total vessel areas and determined the modified American Heart Association lesion type (AHA-LT) on the cross-sectional images. RESULTS: AHA-LT was consistently identified across the same (kappa = 0.75) and different scan platforms (kappa = 0.75). Furthermore, scan-rescan coefficients of variation (CV) of wall area measurements on Siemens and Philips scanners ranged from 6.3% to 7.5%. However, wall area measurements differed between Philips and GE (P = 0.003) and between Siemens and GE (P = 0.05). In general, intrareader reproducibility was higher than interreader reproducibility for AHA-LT identification as well as for quantitative measurements. CONCLUSION: All three scanners produced images that allowed AHA-LT to be consistently identified. Reproducibility of quantitative measurements by Siemens and Philips scanners were comparable to previous studies using 1.5T GE scanners. However, bias was introduced with each scanner and the use of different readers substantially increased variability. We therefore recommend using the same platform and the same reader for scans of individual subjects undergoing serial assessment of carotid atherosclerosis. 相似文献
7.
Contrast-enhanced high resolution MRI for atherosclerotic carotid artery tissue characterization. 总被引:26,自引:0,他引:26
Chun Yuan William S Kerwin Marina S Ferguson Nayak Polissar Shaoxiong Zhang Jianming Cai Thomas S Hatsukami 《Journal of magnetic resonance imaging : JMRI》2002,15(1):62-67
PURPOSE: To determine if a gadolinium-based contrast agent provides additional information for characterization of human plaque tissues, particularly neovasculature. Although high-resolution magnetic resonance imaging (MRI) has been used to identify plaque constituents in advanced atherosclerosis, some constituents, such as neovascularized tissue, defy detection. MATERIALS AND METHODS: Non-contrast-enhanced carotid artery images from 18 patients scheduled for carotid endarterectomy and two normal volunteers were used to identify regions of fibrous tissue, necrotic core, or calcification, using established criteria. Then, the percent change in T1-weighted images after contrast enhancement was calculated for each region. RESULTS: There were statistically significant differences in mean intensity change between tissues, with the largest increase for fibrous tissue (79.5%) and the smallest for necrotic core (28.6%). Additionally, histological analysis showed that a subset of fibrous regions rich in plaque neovascularization could be identified using a threshold of 80% enhancement (sensitivity = 76%, specificity = 79%). CONCLUSION: The ability of contrast-enhanced MRI to identify neovascularization and potentially improve differentiation of necrotic core from fibrous tissue further establishes MRI as a viable tool for in vivo study of atherosclerotic plaque. 相似文献
8.
Qiu B Gao F Walczak P Zhang J Kar S Bulte JW Yang X 《Journal of magnetic resonance imaging : JMRI》2007,26(2):339-343
PURPOSE: To develop a magnetic resonance imaging (MRI)-based method to monitor in vivo trafficking of bone marrow (BM) cells to atherosclerotic lesions. MATERIALS AND METHODS: BM cells from LacZ-transgenic mice were labeled with a superparamagnetic iron oxide (Feridex) and then transplanted into ApoE(-/-) recipient mice that were fed an atherogenic diet. Twenty-four ApoE(-/-) mice were divided into three study groups: 1) group I with Feridex-labeled BM transplantation (BMT) cells (N = 9), 2) group II with unlabeled BMT cells (N = 10), and 3) group III with no BMT cells (N = 5). Migrated Feridex/LacZ-BM cells to atherosclerotic aortic walls were monitored in vivo using a 4.7T MR scanner and correlated with histopathological findings. RESULTS: In group I with Feridex-BMT cells, histology examination displayed plaques in five of nine animals. In four of these five animals, in vivo MRI showed large MR signal voids of the aorta walls (due to the "blooming" effect of migrated Feridex-BM cells in plaques), which were correlated with Feridex- and/or LacZ-positive cells detected in the atherosclerotic lesions. No signal voids could be visualized in the two control animal groups (groups II and III). CONCLUSION: This study demonstrates the potential use of in vivo MRI to monitor the trafficking of magnetically labeled BM cells to atherosclerotic lesions. 相似文献
9.
10.
目的:探讨MR成像技术在颈动脉粥样硬化斑块检测中的应用,及其对斑块内成份进行定性分析的可能性。方法:采用3D-TOF、Double-IR(DIR)T1WI、T2WI、PDWI序列对11位高度疑诊颈动脉粥样硬化的患者及9位健康志愿者进行颈动脉成像。部分患者行彩超对照。结果:11例患者中9例可见明显颈动脉粥样硬化改变。TOF上表现为管腔内高信号血流中见低信号充盈缺损。DIR T1WI、T2WI、PDWI表现为管壁增厚,斑块呈等、低均匀信号或等、低、高混杂信号。与多普勒彩超对比,MRI对颈动脉粥样硬化的检出准确率较高。结论:MRI对颈动脉粥样硬化可达到满意的诊断,并提示MRI能分析斑块内成份,分析斑块成份及性质为临床选择治疗方案及估计预后提供有力的帮助。 相似文献
11.
Blood flow modeling in carotid arteries with computational fluid dynamics and MR imaging 总被引:4,自引:0,他引:4
RATIONALE AND OBJECTIVES: The authors' goal was to develop a noninvasive method for detailed assessment of blood flow patterns from direct in vivo measurements of vessel anatomy and flow rates. MATERIALS AND METHODS: The authors developed a method to construct realistic patient-specific finite element models of blood flow in carotid arteries. Anatomic models are reconstructed from contrast material-enhanced magnetic resonance (MR) angiographic images with a tubular deformable model along each arterial branch. A surface-merging algorithm is used to create a watertight model of the carotid bifurcation for subsequent finite element grid generation, and a fully implicit scheme is used to solve the incompressible Navier-Stokes equations on unstructured grids. Physiologic boundary conditions are derived from cine phase-contrast MR flow velocity measurements at two locations below and above the bifurcation. Vessel wall compliance is incorporated by means of fluid-solid interaction algorithms. RESULTS: The method was tested on imaging data from a healthy subject and a patient with mild stenosis. Finite element grids were successfully generated, and pulsatile blood flow calculations were performed. Computed and measured velocity profiles show good agreement. Flow patterns and wall shear stress distributions were visualized. CONCLUSIONS: Patient-specific computational fluid dynamics modeling based on MR images can be performed robustly and efficiently. Preliminary validation studies in a physical flow-through model suggest that the model is accurate. This method can be used to characterize blood flow patterns in healthy and diseased arteries and may eventually help physicians to supplement imaging-based diagnosis and predict and evaluate the outcome of interventional procedures. 相似文献
12.
目的:应用3.0T MR高分辨管壁成像和MR血管造影在体显示颈动脉粥样斑块,探讨MR对颈动脉斑块的诊断价值。方法:经彩超检查证实的症状性颈动脉狭窄37例,所有病例行管腔MRA和管壁高分辨MR检查,MR检查序列包括3DTOF、DIR T1WI、T2WI、PDWI和MRA。其中,17例检查前1周内行CT血管造影检查,9例患者检查后1周内行颈动脉内膜剥脱术。根据颈动脉内膜剥脱术手术部位,将获得的病理标本与MR图像逐层对照,研究斑块脂质成分、纤维成分和纤维帽、斑块钙化、出血和脂质坏死池等MR表现,探讨斑块变性的MR表现及其病理基础。结果:37个病例共发现52条颈动脉分叉处斑块,其中,管腔轻度狭窄24条(46.1%),中度狭窄19条(36.5%),重度狭窄7条(13.5%),闭塞2条(3.9%)。斑块钙化21条(40.4%)、无钙化斑块31条(59.6%);31条软斑块中纤维成分为主斑块8条(15.6%),有明显脂质核心斑块23条(44.2%);其中,伴斑块出血5条(10%)、脂质坏死核心3条(6%),纤维帽撕裂(溃疡或纤维帽撕裂)3条(6%)。相对于胸锁乳突肌,脂质坏死池在TOF、T1WI、PDWI、T2WI均呈显著高信号,钙化在各序列均呈低信号。斑块内出血的信号与出血的时间有关,新鲜出血各序列表现为点、结节或片状高信号,亚急性出血或者陈旧出血的信号与出血时间长短有关。结论:颈动脉MRA和管壁高分辨成像是评估颈动脉斑块风险性的有效手段,无创性MRA可以显示颈动脉斑块的狭窄程度;管壁高分辨成像可以直接显示斑块纤维帽、斑块内结构和成分,预测斑块脱落的风险性。 相似文献
13.
Cornily JC Hyafil F Calcagno C Briley-Saebo KC Tunstead J Aguinaldo JG Mani V Lorusso V Cavagna FM Fayad ZA 《Journal of magnetic resonance imaging : JMRI》2008,27(6):1406-1411
Purpose
To test whether B‐22956/1, a novel intravascular contrast agent with a high affinity to serum albumin (Bracco Imaging SpA.), allowed quantifying neovessel and macrophage density in atherosclerotic plaques of rabbits using MRI.Materials and Methods
A T1‐weighted MRI of the aorta was acquired in 10 rabbits (7 atherosclerotic and 3 control rabbits) before and up to 2 h after intravenous injection of 100 μmol/kg of Gd‐DTPA or 75 μmol/kg of B‐22956/1. Plaque enhancement was measured at different time points. Immunohistochemistry was performed using anti‐CD 31 antibodies and anti‐RAM 11 antibodies to correlate to neovessel and macrophage density, respectively.Results
MRI showed a significant plaque enhancement 2 h after B‐22956/1 versus Gd‐DTPA in the atherosclerotic group (39.75% versus 9.5%; P < 0.0001. Early atherosclerotic plaques (n = 146) enhancement positively correlates with neovessel density on corresponding histological sections (r = 0.42; P < 0.01). Enhancement of atherosclerotic plaques 2 h after injection of B‐22956/1 correlated with macrophage density (r = 0.71; P < 0.01).Conclusion
Enhancement of atherosclerotic plaques with MRI correlated with neovessel density at early time points after the injection of B‐22956/1 and with macrophage density, at later time points. Hence, B‐22956/1‐enhanced MRI represents a promising imaging technique for the identification of “high‐risk” plaques. J. Magn. Reson. Imaging 2008;27:1406–1411. © 2008 Wiley‐Liss, Inc. 相似文献14.
Human myeloperoxidase: a potential target for molecular MR imaging in atherosclerosis. 总被引:8,自引:0,他引:8
John W Chen Wellington Pham Ralph Weissleder Alexei Bogdanov 《Magnetic resonance in medicine》2004,52(5):1021-1028
Plaque rupture in atherosclerotic disease is the major cause of morbidity and correlates well with myeloperoxidase (MPO) secretion by activated neutrophils and macrophages in humans. We hypothesized that paramagnetic electron donor compounds that rapidly oxidize and polymerize in the presence of MPO could be designed to enable imaging of local MPO activity levels in arterial segments at risk. Several potential substrates for MPO were synthesized and tested. One lead compound consisting of a covalent conjugate of GdDOTA and serotonin (3-(2-aminoethyl)-5-hydroxyindole) was efficiently polymerized in the presence of human neutrophil MPO resulting in a 70-100% increase in proton relaxivity. As a result, we were able to demonstrate MPO activity in enzyme solutions and in a model tissue-like system. These studies suggest that activatable paramagnetic MR imaging agents can be used to directly image MPO activity. 相似文献
15.
Schär M Kim WY Stuber M Boesiger P Manning WJ Botnar RM 《Journal of magnetic resonance imaging : JMRI》2003,17(5):538-544
PURPOSE: To examine the impact of spatial resolution and respiratory motion on the ability to accurately measure atherosclerotic plaque burden and to visually identify atherosclerotic plaque composition. MATERIALS AND METHODS: Numerical simulations of the Bloch equations and vessel wall phantom studies were performed for different spatial resolutions by incrementally increasing the field of view. In addition, respiratory motion was simulated based on a measured physiologic breathing pattern. RESULTS: While a spatial resolution of > or = 6 pixels across the wall does not result in significant errors, a resolution of < or = 4 pixels across the wall leads to an overestimation of > 20%. Using a double-inversion T2-weighted turbo spin echo sequence, a resolution of 1 pixel across equally thick tissue layers (fibrous cap, lipid, smooth muscle) and a respiratory motion correction precision (gating window) of three times the thickness of the tissue layer allow for characterization of the different coronary wall components. CONCLUSIONS: We found that measurements in low-resolution black blood images tend to overestimate vessel wall area and underestimate lumen area. 相似文献
16.
Vitalii V Itskovich Daniel D Samber Venkatesh Mani Juan Gilberto S Aguinaldo John T Fallon Cheuk Y Tang Valentin Fuster Zahi A Fayad 《Magnetic resonance in medicine》2004,52(3):515-523
One of the current limitations of magnetic resonance imaging (MRI) is the lack of an objective method to classify plaque components. Here we present a cluster analysis technique that can objectively quantify and classify MR images of atherosclerotic plaques. We obtained three-dimensional (3D) images from 12 human coronary artery specimens on a 9.4T imaging system using multicontrast-weighted fast spin-echo (T1-, proton density-, and T2-weighted) imaging with an isotropic voxel size of 39 micro. Spatially enhanced cluster analysis (SECA) was performed on multicontrast MR images, and the resulting segmentation was evaluated against histological tracings. To visualize the overall structure of plaques, the MR images were rendered in 3D. The specimens exhibited lesions of American Heart Association (AHA) plaque classification types I-VI. Both MR images and histological sections were independently reviewed, categorized, and compared. Overall, the classification obtained from the cluster-analyzed MR and histopathology images showed very good agreement for all AHA types (92%, Cohen's kappa = 0.89, P < 0.0001). All plaque types were identified and quantified by SECA with a high degree of correlation between cluster-analyzed MR and manually traced histopathology data. MRI combined with SECA provides an objective method for atherosclerotic plaque component characterization and quantification. 相似文献
17.
Boussel L Herigault G de la Vega A Nonent M Douek PC Serfaty JM 《Journal of magnetic resonance imaging : JMRI》2006,23(3):413-415
PURPOSE: To identify and quantify the potential sources of motion in carotid artery imaging. MATERIALS AND METHODS: Two healthy volunteers and 12 patients (20-75 years old) with atherosclerotic disease were scanned on a Philips Intera 1.5T system. A single-shot balanced-fast field echo (bFFE) sequence was used to acquire real-time axial views of the carotid artery wall (three images per second). A three-step acquisition protocol was performed to analyze the three types of motion (arterial pulsation, breathing, and swallowing) separately. The isocenter carotid artery motion amplitude in either the x or y direction was measured. Radial variation in the carotid lumen between the systolic and diastolic phases was analyzed. Motion frequency was reported for each patient. RESULTS: Significant motion related to arterial pulsation (amplitude = 0.27-0.93 mm, mean = 0.6, SD = 0.19), breathing (amplitude = 0.5-3.6 mm, mean = 1.56, SD = 0.99)), and swallowing (amplitude = 1.4-9.2 mm, mean = 4.7, SD = 2.4) were visualized. CONCLUSION: Pulsation, breathing, and swallowing are sources of significant motion in the carotid artery wall. Such motion should be considered in the future to improve carotid artery image quality. 相似文献
18.
Carotid vulnerable lesions are related to accelerated recurrence for cerebral infarction magnetic resonance imaging study 总被引:3,自引:0,他引:3
RATIONALE AND OBJECTIVES: We sought to test the hypothesis that magnetic resonance imaging (MRI)-defined vulnerable plaques correlate to accelerated reoccurrence of cerebrovascular events and to evaluate the potential use of MRI in secondary prevention of ischemic stroke. MATERIALS AND METHODS: Fifty-three symptomatic participants were recruited from patients sustaining their second MRI-confirmed cerebral infarction. Nine participants were women and 44 were men; the mean age was 69.2 years (range, 55-94 years). Patients were imaged within 7 days after the reoccurrence of cerebral infarction. The MRI diagnostic signals defined a classification of lesion type. We compare the interval between two cerebral infarctions with plaque vulnerability defined by the MRI lesion type. We used a Cox proportional hazards model to calculate the relationship between vulnerable lesions and the interval of cerebral infarction, and we followed these patients for 180 days and compared the recurrent rate for the third-time cerebral infarction between patients with and without vulnerable plaque. RESULTS: The mean infarction recurrence interval for patients with vulnerable lesions was shorter than the mean interval for patients without vulnerable lesion (310.1 versus 1697.2, P< .001). In patients with recurrent cerebral infarction within 1 year, vulnerable lesions were more frequently detected (76% versus 19%, P< .001). The patients with vulnerable lesions had an 8.8-fold higher hazard risk (8.8; P< .001, 95% confidence interval, 3.9-19.7) than those without vulnerable lesions after adjustment for risk factors. For those with vulnerable plaque, the morbidity of third-time cerebral infarction was higher than those without (24% versus 3%, P = .023). CONCLUSION: MRI-defined vulnerable lesions in carotid arteries are related to accelerated recurrent cerebral infarction and high recurrent rate. MRI demonstrates clinical value in the secondary prevention of cerebral infarction. 相似文献
19.
目的 研究一种临床适用的MR技术在体无创性评估颈总动脉血管壁切应力(WSS)的方法.方法 选取1名健康志愿者,对其右侧颈总动脉行相位对比法MR血流定量扫描,应用三维抛物面(3DP)模型函数拟合方法,结合图像后处理技术,计算局部WSS,获取颈总动脉的血管横截面积、平均血流速度、最大速度及瞬时血流率等血流动力学参数,综合评估颈总动脉的血流动力学状态.结果 颈总动脉局部WSS值范围为(0.75±0.41)N/m2;平均血流速度为(23.4±12.0)cm/s,血管横截面积为(32.2±2.9)mm2;血流率为(7.8±4.6)ml/s.结论 MR血流定量技术结合3DP模型方法可以对颈动脉局部WSS大小、分布和变化进行评估. 相似文献