复发急性缺血性脑卒中患者大脑中动脉斑块的高分辨率MRI研究

摘要

AbstractObjective:To study the morphological characteristics of middle cerebral artery plaque in patients with recurrent acute ischemic stroke by 3.0 T high resolution magnetic resonance imaging (HR-MRI).Materials and Methods:Retrospective analysis of clinical data of 77 cases of patients with acute ischemic stroke, the culprit plaques in middle cerebral artery, including 36 cases of patients with primary (primary group), 41 cases with recurrence (recurrence group), all patients underwent 3.0 T high resolution magnetic resonance imaging (plaque scanning sequence including TOF-MRA, DWI for the whole brain, T1WI,T2WI and contrast-enhanced T1WI). Comparative analysis of the primary and recurrent patients plaque morphological characteristics included lumen stenosis rate, minimal lumen area, plaque burden, plaque enhancement rate, T1WI and T2WI plaque signal strength index.Results:The lumen stenosis rate (P=0.002), plaque burden (P=0.005) and plaque enhancement ratio (P=0.037) were signiifcantly higher in the recurrent group than in the primary group, and the minimal lumen area (P=0.001) was signiifcantly smaller than that in the primary group. The T2WI signal intensity index of the recurrence group was higher than that of the primary group (P<0.001), while the T1WI signal strength index was not signiifcantly different (P=0.245).Conclusions:High resolution magnetic resonance imaging can effectively evaluate the morphological characteristics of middle cerebral artery plaque in patients with recurrent acute ischemic stroke. Comprehensive evaluation of plaque characteristics can provide reference for the clinical and help to prevent recurrence stroke.%目的：利用3.0 T高分辨磁共振(HR-MRI)研究复发急性缺血性脑卒中患者大脑中动脉斑块形态特征。材料与方法回顾性分析77例责任血管为大脑中动脉的急性缺血性脑卒中患者资料，其中初发患者36例(初发组)，复发患者41例(复发组)，所有患者均行3.0 T高分辨磁共振斑块成像(扫描序列包括TOF-MRA，头颅常规DWI，责任血管轴位T1WI、T2WI及T1WIGd-DTPA增强)。对比分析初发组与复发组急性缺血性脑卒中患者责任血管管腔狭窄率、最小管腔面积、斑块负荷、斑块强化率、T1WI及T2WI斑块信号强度指数。结果复发组患者大脑中动脉管腔狭窄率(P=0.002)、斑块负荷(P=0.005)、斑块强化率(P=0.037)均明显高于初发组，最小管腔面积(P=0.001)明显小于初发组。复发组斑块T2WI信号强度指数大于初发组(P＜0.001)，而T1WI信号强度指数两者无明显差异(P=0.245)。结论高分辨率磁共振可以有效评估复发急性缺血性脑卒中患者大脑中动脉斑块的形态特征，综合评价斑块特征可为临床提供参考以助于预防脑卒中复发。