3.0T磁共振血管壁成像技术对缺血性脑卒中颅内动脉斑块的分析研究

曹杰 杨志宏 曹家驹 吴云 钟美花

【摘要】 目的：研究3.0T磁共振血管壁成像技术（MR-VWI）在缺血性脑卒中（CIS）颅内动脉斑块的诊断价值。方法：回顾性分析2018年1月-2020年6月本院收治的62例CIS患者临床资料，均行颅内动脉MR-VWI检查，按斑块与缺血区责任动脉关系划分为责任动脉斑块组、非责任动脉斑块组。分析责任及非责任动脉斑块MR-VWI特征。结果：62例患者中共存在248处斑块，其中责任动脉斑块与非责任动脉斑块分别为87处（35.08%）、161处（64.92%）。责任斑块与非责任动脉斑块的管腔狭窄程度、斑块位置及强化情况比较，差异均有统计学意义（P<0.05）。责任斑块与非责任动脉斑块的斑块形态比较，差异无统计学意义（P>0.05）。责任斑块组管腔狭窄以<50%为主，斑块位置多见大脑中动脉与基底动脉，斑块强化成明显强化。结论：3.0T MR-VWI用于CIS效果较好，可明确颅内动脉斑块强化程度，评估疾病危险因素，值得推广及应用。

【关键词】 缺血性脑卒中 颅内动脉斑块 3.0T磁共振血管壁成像技术

3.0T MR Vessel Wall Imaging of Intracranial Arterial Plaque in Cerebral Ischemic Stroke/CAO Jie， YANG Zhihong， CAO Jiaju， WU Yun， ZHONG Meihua. //Medical Innovation of China， 2021， 18（31）： 0-023

[Abstract] Objective： To study the diagnostic value of 3.0T magnetic resonance vascular wall imaging （MR-VWI） in the diagnosis of intracranial artery plaque in ischemic stroke （CIS）. Method： The clinical data of 62 patients with CIS admitted to our hospital from January 2018 to June 2020 were retrospectively analyzed， all patients underwent MR-VWI examination of intracranial artery， they were divided into responsible artery plaque group and non-responsible artery plaque group according to the relationship between plaque and responsible artery in ischemic area. The MR-VWI characteristics of responsible and non-responsible arterial plaques were analyzed. Result： A total of 248 plaques were found in 62 patients， including 87 （35.08%） responsible artery plaques and 161 （64.92%） non-responsible artery plaques. There were significant differences in lumen stenosis degree， plaque location and enhancement between responsible plaque and non-responsible artery plaque （P<0.05）. There was no significant difference in plaque morphology between responsible plaque and non-responsible plaque （P>0.05）. In the responsible plaque group， lumen stenosis was less than 50%， and the middle cerebral artery and basilar artery were the most common plaque locations. Conclusion： 3.0T MR-VWI has a good effect on CIS， which can determine the degree of intracranial arterial plaque enhancement and evaluate the risk factors of disease， which is worthy of promotion and application.

[Key words] Cerebral ischemic stroke Intracranial arterial plaque 3.0T MR vessel wall imaging

First-authors address： Jiujiang First Peoples Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.31.005

缺血性腦卒中（cerebral ischemic stroke，CIS）是具有高发生率、高致残率及高致死率的脑血管疾病，因颅内动脉粥样硬化病变所致。近年来，随着我国老龄化局势加剧，该病也呈逐年增长趋势，对患者身心健康造成严重危害[1]。相关研究发现，CIS的发生、发展离不开动脉粥样硬化斑块内炎性范围，可用于评估斑块稳定性[2]。近年来随着医疗技术的更新与发展，3.0T磁共振血管壁成像技术（MR vessel wall imaging，MR-VWI）逐渐被用于诊断脑血管疾病，相比起常规MR扫描能够明确动脉粥样硬化程度及斑块情况[3]。因此，本研究对3.0T MR-VWI用于CIS颅内动脉斑块展开相应的分析，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年1月-2020年6月本院收治的62例CIS患者，其中男37例，女25例;年龄30～74岁，平均（55.18±2.55）岁。纳入标准：（1）经临床影像学检查结合症状表现符合《中国CIS诊治指南》诊断标准[4];（2）年龄≥18岁。……