大脑中动脉粥样硬化性狭窄管腔重构模式的高分辨率磁共振研究

目的应用高分辨率磁共振(HRMRI)研究粥样硬化性大脑中动脉(MCA)重构模式。方法分析我院75例中重度大脑中动脉粥样硬化性狭窄患者的影像学资料,在HRMRI序列上测量大脑中动脉最窄处血管面积(VA_(MLN))和管腔面积(LA_(MLN))及参考处血管面积(VA_(reference))和管腔面积(LA_(reference)),分别计算最窄处管壁面积(WA)、斑块面积(PA)、斑块负荷(PB)、重构分数(RI)、狭窄率(SR);根据重构分数分为阳性重构组和非阳性重构组,比较两组管壁各参数的差异。结果非阳性重构组和阳性重构组的RI分别为(0.86±0.10)和(1.36±0.30),其差异具有统计学意义(P0.001)。在最窄层面,非阳性重构病变与阳性重构病变相比,VA、PA均具有显著差异(P0.001),LA、WA、PB均有统计学差异(P=0.009,P=0.001,P=0.002),而SR在两组之间无统计学差异(P=0.106)。在参考层面非阳性重构和阳性重构之间VA具有显著差异(P=0.013),LA、WA不具有统计学差异(P=0.494,P=0.065)。结论 HRMRI具有清晰显示MCA粥样硬化性狭窄的管壁特征的优势,对于评价病变的重构模式具有重要作用。在MCA动脉粥样硬化性狭窄病变中非阳性重构同阳性重构一样常见。同非阳性重构模式相比,阳性重构模式的血管面积、管腔面积、管壁面积、斑块面积、斑块负荷更大,阳性重构患者病情更为严重,可见评价病变处管腔的重构模式可以帮助临床获取患者的更多信息。

The research of remodeling pattern in middle cerebral artery atherosclerotic disease:high-resolution magnetic resonance

Objective The application of HRMRI in middle artery atherosclerotic remodeling pattern.Methods Seventy-five cases of moderate to severe middle cerebral artery atherosclerotic stenosis imaging data were analyzed.Vessel area and lumen area of maximum stenosis in middle cerebral artery and reference were measured respectively.The WA,PA,PB,RI,SR were calculated respectively.According to the remodeling index,75 cases were divided into positive remodeling and non-positive remodeling group.The parameters were compared between two groups.Results The RI in two groups were (0.86±0.10) and (1.36±0.30) respectively.There was significant difference between the two groups (P<0.001).VA,PA was significantly different in two groups at the maximum luminal narrow site (P<0.001).LA,WA,PB was significantly different in two groups (P=0.009,P=0.001,P=0.002).As for SR,there was no significantly different between two groups (P=0.106).VA was significantly different between two groups at reference site (P=0.013).LA and WA was no significant difference between two groups(P=0.494,P=0.065).Conclusion The features of the MCA atherosclerotic stenosis was clearly shown in the HRMRI.That was important for evaluating the remodeling pattern.Non-PR was as normal as PR.The VA,LA,WA,PA and PB in PR was bigger than that in non-PR.The patients in PR group was more terrible than non-PR group.In a word,evaluating the remodeling pattern was beneficial for patients.