3.0TMRI对颈动脉粥样硬化斑块成分分析及分型的研究

目的：探讨3.0 T高分辨磁共振成像对颈动脉粥样硬化斑块内部成分检出及斑块稳定性判定的价值。材料与方法33例颈动脉粥样硬化斑块患者行MRI检查，扫描序列包括三维时间飞跃法(3D-TOF)成像、双翻转T1加权成像、T2加权成像、质子密度(PD)加权成像及增强颈部血管成像，研究、分析斑块内成分及其分型。结果33例患者中共检出颈动脉粥样硬化斑块63个，分型如下：Ⅰ-Ⅱ型占12.7%，Ⅲ型占27%，Ⅳ-Ⅴ型占19%，Ⅵ型占31.8%，Ⅷ型占9.5%，各型斑块在颈动脉3个部位的分布差异无统计学意义(Fisher确切概率P=0.106)；所有检出的颈动脉斑块中稳定斑块共31个，不稳定斑块共32个，二者在是否出现脂质核心(LRNC)、出血(IPH)、血栓形成及纤维帽(FC)破裂方面均有统计学差异(P＜0.05)，而钙化出现率无统计学差异(P＞0.05)。结论3.0 T高分辨率MRI能识别、区分颈动脉粥样斑块内成分，能鉴别稳定斑块和不稳定斑块，为临床选择治疗方案及疗效评价提供指导。

Carotid atherosclerotic plaque composition analysis and classiifcation with 3.0 T MRI

Objective:To discuss the capability of 3.0 T high resolution MRI to differentiate carotid atherosclerotic plaque composition and to predict plaque stability.Materials and Methods:Thirty-three consecutive patients with carotid atherosclerotic plaques were scanned using GE 3.0 T MRI. MRI protocols include three-dimensional time-of-flight (3D-TOF), double-inversion recovery T1 weighted image, T2 weighted image, proton density weighted image and carotid artery MRA. Plaque composition and its type were collected and analysed.Results:Total 63 carotid atherosclerotic plaques were found in 33 patients. According to American Heart Association classification, typeⅠ-Ⅱ plaques accounts for 12.7% of total plaques, typeⅢ accounts for 27% of total, typeⅣ-Ⅴ together occupies 19% of them, typeⅥ with number of 31.8% is the biggest in the group, and typeⅧ accounts for 9.5%. There was no statistically significant difference for plaque location (Fisher’s exact test:P=0.016). Thirty one stable plaques and 32 unstable plaques were detected of all 63 plaques. There was statistically signiifcant difference between stable plaque group and unstable plaque group in terms of the occurrence rate of lipid rich necrotic core, hemorrhage, thrombosis and integrity of fibrous cap (P<0.05). No significant differences were found for the number of calcification (P>0.05) between the two groups.Conclusion:3.0 T high resolution MRI has the capability to differentiate and identify plaque compositions between table plaque group and unstable plaque group. It can be an important guidance for treatment option and outcome evaluation.