不同机制的症状性颅内动脉粥样硬化患者HRMRI斑块特征分析

目的 分析不同机制的症状性颅内动脉粥样硬化患者高分辨率磁共振成像(HRMRI)斑块特征。方法 收集2019年1月-2019年12月在江苏大学附属宜兴医院神经内科就诊的脑梗死患者60例,参照中国缺血性脑卒中亚型(CISS)分型标准,并根据颅脑DWI表现将症状性动脉粥样硬化性颅内动脉狭窄(sICAS)患者分为动脉—动脉栓塞组(A组)、低灌注或混合性脑梗死组(B组)、穿支动脉受累组(C组)各20例。另外,同期选取20例无症状性ICAS患者作为无症状性ICAS组(D组); 所有患者均行HRMRI扫描,评价斑块特征。结果 4组患者颅内动脉粥样硬化斑块形态、分布、强化、斑块内信号、责任动脉的狭窄程度、病变管壁体积百分比比较无明显差异(P>0.05); 4组患者颅内动脉粥样硬化斑块部位、病变局部血管重构指数特征比较有明显差异(P<0.05)。A,B,C组患者颅内动脉粥样硬化斑块部位、病变局部血管重构指数特征比较无明显差异(P>0.05)。结论 HRMRI可作为分析症状性颅内动脉粥样硬化患者斑块特征,但不同机制的斑块特征无明显差异

HRMRI plaque characteristics of symptomatic intracranial atherosclerosis patients with different mechanisms

ObjectiveTo analyze the plaque characteristics of high resolution magnetic resonance imaging(HRMRI)in patients with symptomatic intracranial atherosclerosis of different mechanisms.Methods Sixty patients with cerebral infarction from January 2019 to December 2019 in the Department of Neurology, Yixing Hospital Affiliated to Jiangsu University were collected. According to the classification criteria of ischemic stroke subtype(CISS)in China and the manifestations of cerebral DWI, symptomatic atherosclerotic intracranial arterial stenosis(sICAS)patients were divided into arteries-arteries embolization group(group A)(n=20), hypoperfusion or mixed cerebral infarction group(group B)(n=20)and perforator artery involvement group(group C)(n=20). In addition, 20 asymptomatic ICAS patients were selected as asymptomatic ICAS group(group D)(n=20). All patients underwent HR MRI scan to evaluate plaque characteristics.Results There were no significant differences in the shape, distribution, enhancement, signal within the plaque, stenosis degree of the responsible artery and the percentage of lesion wall volume among the four groups(P>0.05). There were significant differences in the location of intracranial atherosclerotic plaque and the characteristics of local vascular remodeling parameter of lesions among four groups(P<0.05). There was no significant difference in the location of intracranial atherosclerotic plaques and the characteristics of vascular remodeling parameter among group A, group B and group C(P>0.05).Conclusion HRMRI could be used to analyze plaque characteristics in patients with symptomatic intracranial atherosclerosis, but there was no significant difference in plaque characteristics of different mechanisms