3.0T高分辨率MR血管壁成像评估他汀类药物治疗颅内动脉粥样硬化斑块效果

目的 观察3.0T高分辨率MR血管壁成像（HRMR-VWI）评估他汀类药物治疗颅内动脉粥样硬化斑块效果的价值。方法 回顾47例动脉粥样硬化性脑梗死患者（共64个斑块）规范他汀类药物治疗前及治疗后随访（104~486天）期间头部3.0T HRMR-VWI，根据斑块特征有无变化分为治疗有效组（有效组）和治疗无效组（无效组），以单因素及多因素logistic回归分析筛选影响疗效的因素。结果 有效组45个、无效组19个斑块，组间斑块出血及强化差异均有统计学意义（P均<0.05）；斑块强化为他汀类药物治疗效果的独立影响因素（OR=13.500，P=0.003）。37个前循环斑块中，28个治疗有效、9个治疗无效，其间管腔正性重构、斑块出血及强化差异均有统计学意义（P均<0.05）；斑块强化为前循环斑块疗效的独立影响因素（OR=20.00，P=0.018）。结论 3.0T HRMR-VWI可用于评估他汀类药物治疗颅内动脉硬化斑块效果。

3.0T high resolution MR vascular wall imaging for evaluating therapeutic effect of statin for intracranial atherosclerotic plaque

Objective To explore the value of 3.0T high resolution MR vascular wall imaging (HRMR-VWI) for evaluating therapeutic effect of statin for intracranial atherosclerotic plaques. Methods Data of 3.0T HRMR-VWI of 47 clinically diagnosed atherosclerotic cerebral infarction patients with totally 64 plaques before statin therapy and during follow-up were retrospectively analyzed. The changes of plaque characteristics on HRMR-VWI before treatment and during 104-486 days'' following-up were comparatively observed, and the plaques were divided into effective group or ineffective group. Univariate and multivariate logistic regression analysis were used to screen the impact factors of therapeutic effect. Results There were 45 plaques in effective group and 19 plaques in ineffective group. Significant differences of plaque hemorrhage and enhancement were found between groups (both P<0.05), and plaque enhancement was an independent impact factor of therapeutic effect (OR=13.500, P=0.003). There were 37 anterior circulation plaques, 28 in effective group and 9 in ineffective group, and significant differences of positive remodeling, plaque hemorrhage and enhancement were found (all P<0.05), and plaque enhancement was also an independent impact factor for therapeutic effect of anterior circulation plaques (OR=20.00, P=0.018). Conclusion 3.0T HRMR-VWI could be used to evaluate therapeutic effect of statin for intracranial atherosclerotic plaques.