大脑中动脉狭窄的高分辨力MRI管壁成像特点研究
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摘要
目的 :应用1.5T高分辨力磁共振成像(high resolution magnetic resonance imaging,HR MRI)对症状性和无症状性大脑中动脉(middle cerebral artery,MCA)粥样硬化狭窄管壁进行成像,探讨症状性和无症状性MCA粥样硬化狭窄的管壁特点。方法:收集2015年1月至2017年6月经MRA或CTA证实的MCA M1段明显狭窄(≥50%)的行HR MRI检查的患者36例,其中有症状组25例,无症状组11例,分别测量最窄层面的血管横轴位管壁厚度、管腔的横截面积,比较2组患者血管狭窄的差异。采用SPSS 17.0统计软件分析数据。结果:有症状组MCA狭窄段的管腔面积为(3.04±1.03)mm2,无症状组MCA狭窄段的管腔面积为(3.28±0.96)mm2,2组之间的管腔面积差异无统计学意义(P>0.05);与无症状组MCA狭窄段的管壁厚度[(2.10±0.77)mm]相比,有症状组MCA狭窄段的管壁明显增厚,约为(2.32±0.61)mm,且注射对比剂后,有症状组的偏心性强化更多见(83.3%)。结论:HR MRI可以显示症状性和无症状性患者MCA粥样硬化性狭窄段管壁的不同特征,症状性患者的MCA在HR MRI上显示较大的管壁厚度,管壁强化更多见。
Objective To compare images of the vessel wall between symptomatic and asymptomatic atherosclerotic plaques of the middle cerebral artery(MCA) using high resolution magnetic resonance imaging(HR MRI). Methods HR MRI data were acquired in 36 patients with MCA atherosclerotic stenosis(≥50%) confirmed by MRA, CTA, of whom, 25 symptomatic patients and 11 asymptomatic ones were enrolled into a symptomatic group and an asymptomatic group respectively. The wall thickness and cross-sectional area of stenotic segments were measured and compared between the two groups. The data were analyzed by SPSS 17.0 statistical software. Results The cross-sectional area in the symptomatic group was(3.04±1.03)mm2,while the asymptomatic group was(3.28±0.96)mm2, and the difference between the two groups was not statistically significant(P>0.05). The symptomatic group had a larger wall thickness((2.32±0.61)mm) when compared with the asymptomatic group((2.10±0.77)mm), and higher prevalence of plaque enhancement after contrast injection(83.3%). Conclusion Different vessel wall properties on HR MRI are observed between symptomatic and asymptomatic MCA stenosis. Symptomatic MCA stenosis has a larger wall thickness and higher prevalence of plaque enhancement after contrast injection when compared with the asymptomatic.
Objective To compare images of the vessel wall between symptomatic and asymptomatic atherosclerotic plaques of the middle cerebral artery(MCA) using high resolution magnetic resonance imaging(HR MRI). Methods HR MRI data were acquired in 36 patients with MCA atherosclerotic stenosis(≥50%) confirmed by MRA, CTA, of whom, 25 symptomatic patients and 11 asymptomatic ones were enrolled into a symptomatic group and an asymptomatic group respectively. The wall thickness and cross-sectional area of stenotic segments were measured and compared between the two groups. The data were analyzed by SPSS 17.0 statistical software. Results The cross-sectional area in the symptomatic group was(3.04±1.03)mm2,while the asymptomatic group was(3.28±0.96)mm2, and the difference between the two groups was not statistically significant(P>0.05). The symptomatic group had a larger wall thickness((2.32±0.61)mm) when compared with the asymptomatic group((2.10±0.77)mm), and higher prevalence of plaque enhancement after contrast injection(83.3%). Conclusion Different vessel wall properties on HR MRI are observed between symptomatic and asymptomatic MCA stenosis. Symptomatic MCA stenosis has a larger wall thickness and higher prevalence of plaque enhancement after contrast injection when compared with the asymptomatic.
引文
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[14]丁洪园,张玲,杨云.对比增强MR血管成像在下肢动脉疾病中的应用[J].医疗卫生装备,2016,37(11):66-68.
[15]刘睿,张华,黄华.利用超声波与核磁共振影像对正常变化的脑血管循环评测[J].医疗卫生装备,2010,31(12):5-7.
[2]谢珊珊,张勇.高分辨率MRI在大脑中动脉粥样硬化性狭窄的应用[J].实用放射学杂志,2014,30(1):167-169,194.
[3]娄昕,姜卫剑,马林,等.重度颅内动脉狭窄活体高分辨磁共振成像初探[J].中华内科杂志,2008,47(6):478-481.
[4]RYU C W,JAHNG G H,KIM E J,et al.High resolution wall and lumen MRI of the middle cerebral arteries at 3 tesla[J].Cerebrovasc Dis,2009,27(5):433-442.
[5]SWARTZ R H,BHUTA S S,FARB R I,et al.Intracranial arterial wall imaging using high-resolution 3-tesla contrastenhanced MRI[J].Neurology,2009,72(7):627-634.
[6]杨利新,董莉,于薇.颈动脉斑块内出血的高分辨率MR成像临床应用与技术进展[J].磁共振成像,2015,6(9):711-715.
[7]李梅芳,许祖梅.HR-MRI脑动脉成像研究进展[J].温州医科大学学报,2016,46(9):699-703.
[8]GLAGOV S,WEISENBERG E,ZARINS C K,et al.Compensatory en-largement of human atherosclerotic coronary arteries[J].New England J Med,1987,316(22):1 371-1 375.
[9]张丹凤.高分辨力MR成像检查大脑中动脉粥样硬化斑块的研究进展[J].国际医学放射学杂志,2017,40(2):141-143.
[10]贾泽军,赵瑞,杨志刚,等.基于3.0 T高分辨率磁共振成像的大脑中动脉粥样硬化性狭窄研究进展[J].南方医科大学学报,2015,35(1):154-159.
[11]HARDIE A D,KRAMER C M,RAGHAVAN P,et al.The impact of expansive arterial remodeling on clinical presentation in carotid artery disease:a multidetector CT angiography study[J].Amer J Neurorad,2007,28(6):1 067-1 070.
[12]YUAN C,KERWIN W S,FERGUSON M S,et al.Contrastenhanced high resolution MRI for atherosclerotic carotid artery tissue characterization[J].J Magn Res Imag,2002,15(1):62-67.
[13]KOOPS A,ITTRICH H,PETRI S,et al.Multicontrast-weighted magnetic resonance imaging of atherosclerotic plaques at 3.0 and 1.5 Tesla:ex-vivo comparison with histopathologic correlation[J].Eur Radiol,2007,17(1):279-286.
[14]丁洪园,张玲,杨云.对比增强MR血管成像在下肢动脉疾病中的应用[J].医疗卫生装备,2016,37(11):66-68.
[15]刘睿,张华,黄华.利用超声波与核磁共振影像对正常变化的脑血管循环评测[J].医疗卫生装备,2010,31(12):5-7.
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