高分辨率磁共振管壁成像对缺血性卒中病因的精准诊断价值

doi:10.3969/j.issn.1673-5765.2021.01.007

摘要/Abstract

摘要：

目的探讨HR-MRI管壁成像对于缺血性卒中病因精准化诊断的价值。方法回顾性分析2014年5月-2019年5月发病2周内入院且住院期间完善了责任血管或责任血管载体动脉HR-MRI扫描的急性缺血性卒中患者的临床及影像学资料。依据CISS分型标准，于HR-MRI扫描前后对入组患者分别进行病因分型，以探讨HR-MRI对于缺血性卒中病因精准化诊断的价值。结果共入组139例患者。HR-MRI扫描前的CISS分型为：大动脉粥样硬化（large artery atherosclerosis， LAA）89例，穿支动脉疾病（penetrating artery disease，PAD）45例，其他病因（other etiology，OE）3 例，病因不确定（undetermined etiology，UE）2例。经HR-MRI扫描后CISS分型为：LAA型108例，PAD型27例， OE型4例。PAD型18例及OE型1例经HR-MRI扫描证实为LAA型，UE型2例经HR-MRI扫描明确病因为OE型，共修正21例（15.11%）患者的病因诊断。结论 HR-MRI可显示正性重构、微小动脉粥样硬化斑块等颅内动脉管壁特征，可协助明确卒中病因，实现临床医师对卒中患者的精准化诊治。

文章导读： 应用HR-MRI显示颅内动脉管壁细微结构特征，可协助临床医师明确卒中病因分型，实现临床医师对卒中患者的精准化诊治。

关键词: 缺血性卒中; 病因诊断; 高分辨率磁共振成像; 管壁成像

Abstract:

Objective To evaluate the value of high resolution vessel wall MRI in the etiological diagnosis of ischemic stroke. Methods The clinical and imaging data of patients with acute ischemic stroke who were admitted to our hospital within 2 weeks of onset from May 2014 to May 2019 and had completed HRMRI scan of culprit vessel or the parent artery of culprit vessel during hospitalization were retrospectively analyzed. The etiological diagnosis was made before and after HR-MRI scan in all the patients, according to the CISS criteria. The value of HR-MRI in the etiological diagnosis of ischemic stroke was analyzed. Results A total of 139 patients were included. The etiological diagnosis profile before HR-MRI scan: 89 cases with large artery atherosclerosis (LAA) subtype, 45 cases with penetrating artery disease (PAD) subtype, 3 cases with other etiology (OE) subtype and 2 cases with undetermined etiology (UE) subtype. The etiological diagnosis profile after HR-MRI scan: 108 cases with LAA subtype, 27 cases with PAD subtype, and 4 cases with OE subtype. Though HR-MRI scan, 18 cases with the initial diagnosis of PAD subtype and 1 case with the initial diagnosis of OE subtype were finally diagnosed with LAA subtype, and 2 cases with the initial diagnosis of UE subtype were finally diagnosed with OE subtype, so the final diagnosis of 21 cases (15.11%) was modified through HR-MRI. Conclusions HR-MRI can clearly show the structure of intracranial vessel wall, which is helpful for clinicians to make accurate diagnosis and treatment for stroke patients.

Key words: Ischemic stroke; Etiological diagnosis; High-resolution magnetic resonance imaging; Vessel wall imaging

李文君，刘翠翠，刘俊艳. 高分辨率磁共振管壁成像对缺血性卒中病因的精准诊断价值[J]. 中国卒中杂志, 2021, 16(01): 39-44.

LI Wen-Jun, LIU Cui-Cui, LIU Jun-Yan. The Value of High Resolution Vessel Wall Magnetic Resonance Imaging in the Etiological Diagnosis of Ischemic Stroke[J]. Chinese Journal of Stroke, 2021, 16(01): 39-44.

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