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目的通过高分辨MRI(HR-MRI)探讨大脑中动脉粥样硬化斑块的分布特点及斑块性质。方法前瞻性纳入经颅脑MRA检查证实大脑中动脉M1段有粥样硬化斑块的患者52例,所有病例均为单侧发病。依据DWI及临床表现分为症状性组(27例)和非症状性组(25例),对大脑中动脉动脉粥样硬化斑块处行HR-MRI扫描。结果症状性组27例,21例为易损性斑块;非症状性组25例,11例为易损性斑块。两组比较易损性斑块的发生率差异有统计学意义(P=0.012)。症状性组斑块最大厚度为(1.80±0.33)mm,非症状性组斑块最大厚度为(1.51±0.37)mm,两组比较差异有统计学意义(P=0.004)。大脑中动脉粥样硬化斑块易发生于管腔前壁(22/52),其次为管腔下壁(13/52)。单因素分析症状性组与非症状性组斑块分布部位的差异无统计学意义(P>0.05)。结论HR-MRI可有效的对大脑中动脉粥样硬化斑块进行定位、定量、定性分析,为临床诊断及治疗提供影像依据。
Objective To investigate the distribution and plaque characteristics of atherosclerotic plaques in the brain by high resolution MRI (HR-MRI). Methods Fifty-two patients with atherosclerotic plaques in M1 segment of middle cerebral artery were prospectively enrolled in MRA examination. All cases were unilateral. According to DWI and clinical manifestations, the patients were divided into symptomatic group (n = 27) and non-symptomatic group (n = 25). HR-MRI was performed on atherosclerotic plaques of middle cerebral artery. Results Symptomatic group of 27 cases, 21 cases of vulnerable plaque; non-symptomatic group of 25 cases, 11 cases of vulnerable plaque. There was a significant difference in the incidence of more vulnerable plaques in both groups (P = 0.012). The maximum thickness of symptomatic plaque was (1.80 ± 0.33) mm, and the maximum thickness of nonsymptomatic plaque was (1.51 ± 0.37) mm. The difference between the two groups was statistically significant (P = 0.004). Middle cerebral artery atherosclerotic plaques occur easily in the anterior lumen (22/52), followed by the lumen (13/52). Univariate analysis of symptomatic group and non-symptomatic group plaque distribution of the difference was not statistically significant (P> 0.05). Conclusion HR-MRI can effectively locate, quantitatively and qualitatively detect atherosclerotic plaque in the middle cerebral artery to provide the basis for clinical diagnosis and treatment.