颈动脉粥样硬化斑块高分辨磁共振成像扫描方法

目的:规范颈动脉粥样硬化斑块高分辨磁共振成像方法,优化扫描序列及参数.材料和方法:采用颈动脉专用线圈,选用2D-TOF、3D-TOF、T1WI、T2WI、PDWI等脉冲序列,对156例不同程度脑缺血症状患者行颈动脉斑块多序列多方位扫描.结果:156例受检者除2名不能配合未完成扫描外,其余均顺利完成.T1WI、T2WI、PDWI和3D-TOF的序列组合能准确显示血管壁、血流、斑块大小、形态及斑块内成分.其中62例显示明确斑块形成(最大狭窄＞50%),34例判定为稳定斑块;28例判定为不稳定斑块,其中手术病理证实22例,病理提示斑块纤维帽不完整、部分合并出血钙化及巨大脂质池.结论:采用颈动脉专用表面线圈,选用合适的扫描序列及参数所得到的图像能有效显示斑块,为临床治疗方案的选择及术后随访提供依据.

Scan Strategy for High Resolution MRI of Atherosclerotic Carotid Plaque

Purpose: To develop optimal scan sequences and parameters of high resolution MRI for atherosclerotic carotid plaque.Materials and Methods: Carotid MR examination was acquired in 156 patients with brain ischemic symptom by using a phase-array carotid coil.The sequences were used including 2D-TOF,3D-TOF,T1WI,T2WI and PDWI.Results: All patients had completed the examination successfully except two patients because of incorporation.The wall of the carotid artery,the blood flow,the size and the content of the plaque could be demonstrated clearly by using T1WI,T2WI,PDWI and 3D-TOF.Sixty-two arteries showed obvious atherosclerotic carotid plaque(Stenosis>50%).Among them,34 arteries were stable plaque and 28 arteries were unstable plaque.Twenty-two arteries with histological results were revealed the unstable factor of the plaque including the rupture of the fibrous cap,hemorrhage,calcification and large lipid core.Conclusion: Selecting the proper scanning sequences and using special carotid superficial coil are efficient to acquire the images of carotid atherosclerotic plaque.It will be useful for the clinical treatment design and follow-up after carotid endarterectomy.