后循环脑缺血的基底动脉高分辨磁共振成像研究

目的利用高分辨磁共振成像(high-resolution magnetic resonance imaging,HR-MRI)探究短暂性脑缺血发作(transient ischemic attack,TIA)频发组与非频发组间基底动脉管壁差异。材料与方法将经过头部三维时间飞跃法磁共振血管造影(three-dimension time of flight magnetic resonance angiography,3D-TOF-MRA)和基底动脉HR-MRI扫描后发现斑块的患者纳入研究。根据24 h内TIA频次分为频发组(≥2次)和非频发组(<2次)。对两组斑块形态学指标、狭窄程度、血管重构、斑块分布及临床特点进行分析。结果68例TIA患者,共184个斑块(频发组:38例、108个,非频发组:30例、76个)。最狭窄层面的斑块形态学指标组间差异均有统计学意义(P均<0.05)。频发组狭窄程度、重构指数较非频发组高,差异均有统计学意义(P均<0.05)。频发组腹侧斑块占比较大(38.0%vs 22.4%),背侧斑块占比较小(17.6%vs 35.5%),差异均有统计学意义(P=0.025、0.006);两组侧壁斑块比例(44.4%vs 42.1%)相似,差异无统计学意义(P=0.753)。两组临床因素差异均无统计学意义(P均>0.05)。结论频发组斑块多分布于腹侧,非频发组多分布于背侧,两组侧壁斑块比例相似。频发组斑块负荷、狭窄程度、重构指数更高,非频发组斑块更稳定。

The reasearch of basilar artery based on high-resolution magnetic resonance imaging in patients with posterior circulation ischemic attack

Objective:The differences of basilar artery vessel wall between frequent patients and non-frequent patients with transient ischemic attack(TIA)were analyzed using high-resolution magnetic resonance imaging(HR-MRI).Materials and Methods:The patients were scanned by three-dimension time of flight magnetic resonance angiography(3D-TOF-MRA)of the head and HR-MRI of basilar artery,and the patients with plaques were enrolled in the study.According to the frequency of TIA within 24 hours,the patients were divided into the frequent group(≥2)and the non-frequent group(<2).The plaque morphological indexes,degree of stenosis,remodeling index,plaque distribution and clinical characteristics between the two groups were analyzed.Results:Sixty-eight patients with TIA(38 cases in the frequent group and 30 cases in the non-frequent group)had a total of 184 plaques(108 in the frequent group and 76 in the non-frequent group).At the maximal-lumen-narrowing site,the plaque morphological indexes in the frequent group were significantly different from those in the non-frequent group(P<0.05).The degree of stenosis and remodeling index in the frequent group were higher than those in the non-frequent group,and the differences were statistically significant(P<0.05).The plaques located at ventral wall of the frequent group(38.0%)accounted for a higher proportion as compared with the non-frequent group(22.4%)(P=0.025),and the plaques located at dorsal wall of the frequent group(17.6%)accounted for a lower proportion as compared with the non-frequent group(35.5%)(P=0.006).The proportion of lateral wall plaques in the frequent group(44.4%)was similar to that in the non-frequent group(42.1%),with no statistically significant difference(P=0.753).The clinical characteristics had no statistically significant differences between the two groups(P>0.05).Conclusions:Most of the plaques are distributed on the ventral side in the frequent group and on the dorsal side in the non-frequent group,and the proportion of lateral plaques are similar between the two groups.In the frequent group,plaque burden is higher,artery stenosis is more severe,and the remodeling index is higher.Plaques in the non-frequent group are relatively more stable.