颅内动脉粥样硬化三维流动散相磁共振成像的可行性

卒中杂志 ›› 2012, Vol. 7 ›› Issue (11): 839-844.

颅内动脉粥样硬化三维流动散相磁共振成像的可行性

刘梦琦1，马宁2，姜卫剑3，马林1，娄昕1

1中国人民解放军总医院放射科
2首都医科大学附属北京天坛医院脑血管病中心急诊介入科
3中国人民解放军第二炮兵总医院脑血管病中心

收稿日期:2012-03-24 出版日期:2012-11-20 发布日期:2012-11-20
通讯作者: 娄昕
基金资助:
国家自然科学基金青年项目（81101034）

Feasibility of Three-Dimentional Flow-Dephasing Magnetic Resonance Imaging in Detecting Atherosclerosis of Intracranial Arteries

*Department of Radiology, People's Liberation Army General Hospital, Beijing 100853, China

Received:2012-03-24 Online:2012-11-20 Published:2012-11-20
Contact: LOU Xin.

摘要/Abstract

摘要：

【摘要】目的探讨使用三维流动散相磁共振成像技术进行颅内动脉粥样硬化斑块成像的可行性。方法在3.0T磁共振扫描仪上对10例经数字减影血管造影证实症状性颅内动脉狭窄程度>70%的患者进行颅内动脉斑块成像，扫描序列包括三维流动散相准备的梯度回波成像序列（three dimensional flow-dephasing-prepared fast spoiled gradient recalled echo，3D FDP-FSPGR）和二维双反转恢复序列（two dimensional double inversion recovery，2D DIR），比较两个序列所得图像的对比噪声比、管腔面积与斑块面积测量结果。结果 3D FDP-FSPGR和2D DIR图像的对比噪声比分别为10.16±4.28和14.81±5.26，差异无显著性（t =2.03，P >0.05）。测量3D FDP-FSPGR和2D DIR图像的狭窄处管腔面积分别为2.2±1.2 mm2和2.2±1.3 mm2，斑块面积分别为18.8±1.4 mm2和18.5±0.9 mm2，均具有较好的一致性（管腔面积组间相关系数＝0.96，斑块面积组间相关系数＝0.95）。2D DIR成像范围8 mm，扫描时间4.8 min，3D FDPFSPGR成像范围48 mm，扫描时间3.7 min。结论与2D DIR相比，3D FDP-FSPGR可在较短时间内获取大范围颅内动脉主干的三维管壁图像，图像质量可以满足临床需求，成像技术可靠，能为临床制订治疗方案提供更全面准确的影像学依据。

关键词: 磁共振成像; 序列; 颅内动脉; 动脉粥样硬化

Abstract:

【Abstract】 Objective To explore the feasibility of three dimensional flow-dephasing-prepared fast spoiled gradient recalled echo(3D FDP-FSPGR) in detecting the laque of intracranial artery using 3.0T MR scanner.

Methods Ten patients with intracranial artery stenosis >70% confirmed by digital subtraction angiography were enrolled in this study. 3D FDP-FSPGR and two dimensional double inversion recovery(2D DIR) were performed in all patients. The contrast-noise-ratio, the lumen area and plaque area which the two sequences were measured and compared.

Results The contrast-noise-ratio of 3D FDP-FSPGR was 10.16±4.28 and 2D DIR was 14.81±5.26, there were no statistically significant differences etween the two sequences(t =2.03, P <0.05). Lumen area and plaque area from 3D FDP-FSPGR and 2D DIR techniques highly correlated(ICCs of 0.96 and 0.95, respectively). The results measured of two sequences were 2.2±1.2 mm2 and 2.2±1.3 mm2 for lumen area, 18.8±1.4 mm2 and 18.5±0.9 mm2 for plaque area, respectively. The scan ranges of two sequences were 48 mm and 8 mm, respectively, and the scan time were 3.7 minutes and 4.8 minutes, spectively.

Conclusions 3D FDP-FSPGR is able to acquire the three dimensional wall images of main intracranial arterial trunk with larger coverage in shorter scan time compared with 2D DIR. It may provide more comprehensive accurate information for clinical therapeutic because of the satisfying image quality and reliable technology.

Key words: Magnetic resonance imaging; Sequence; Intracranial artery; Atherosclerosis

刘梦琦1，马宁2，姜卫剑3，马林1，娄昕1. 颅内动脉粥样硬化三维流动散相磁共振成像的可行性[J]. 卒中杂志, 2012, 7(11): 839-844.

LIU Meng-Qi*, MA Ning, JIANG Wei-Jian, MA Lin, LOU Xin.. Feasibility of Three-Dimentional Flow-Dephasing Magnetic Resonance Imaging in Detecting Atherosclerosis of Intracranial Arteries[J]. Chinese Journal of Stroke, 2012, 7(11): 839-844.

参考文献

参考文献

1 张林峰, 杨军, 武阳丰, 等. 我国人群中缺血性和出血性脑卒中发病的相对比例[J]. 中华内科杂志, 2003,42:94-97.

2 Wong KS, Huang YN, Yang HB, et al. A door-todoor survey of intracranial atherosclerosis in Liangbei County China[J]. Neurology, 2007, 68:2031-2034.

3 Niizuma K, Shimizu H, Takada S, et al. Middle cerebral artery plaque imaging using 3-Tesla highresolution MRI[J]. J Clin Neurosci, 2008, 15:1137-1141.

4 Klein IF, Lavallée PC, Mazighi M, et al. Basilar Artery Atherosclerotic Plaques in Paramedian and Lacunar Pontine Infarctions:A high-resolution MRI study[J]. Stroke, 2010, 41:1405-1409.

5 Yoshida K, Narumi O, Chin M, et al. Characterization of carotid atherosclerosis and detection of soft plaque with use of black-blood MR imaging[J]. AJNR Am J Neuroradiol, 2008, 29:868-874.

6 Chen XY, Wong KS, Lam WW, et al. Middle cerebral ar tery atherosclerosis:histological comparison between plaques associated with and not associated with infarct in a ostmortem study[J]. Cerebrovasc Dis, 2008, 25:74-80.

7 Ma N, Lou X, Zhao TQ, et al. Intraobserver and interobserver variability for measuring the wall area of the basilar artery at the level of the trigeminal ganglion on high-resolution MR images[J]. AJNR Am J Neuroradiol, 2011, 32:E29-32.

8 Lou X, Ma L, Wang FL, et al. Susceptibility-Weighted Imaging in the Diagnosis of Early Basal Ganglia Germinoma[J]. AJNR Am J Neuroradiol, 2009,30:1694-1699.

9 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 ]. 中华内科学杂志, 2008,47:478-481.

10 Ma N, Jiang WJ, Lou X, et al. Arterial remodeling of advanced basilar atherosclerosis:A 3-tesla MRI study[J]. Neurology, 2010, 75:253-258.

11 Klein IF, Lavallée PC, Schouman-Claeys E, et a1.High-resolution MRI identifies basilar artery plaques in paramedian pontine infarct[J]. Neurology, 2005,64:551-552.

12 Van der Kolk AG, Zwanenburg JJ, Brundel M, et al. Intracranial Vessel Wall Imaging at 7.0-T MRI[J].Stroke, 2011, 42:2478-2484.

13 Qiao Y, Steinman DA, Qin Q, et al. Intracranial ar terial wall imaging using 3D high isotropicresolution black blood MRI at 3.0 T[J]. J Magn Reson Imaging, 2011, 34:22-30.

[1]	鲁燕, 杨保荣, 黄向萍, 杨冠桂, 陈圣文, 李建荣, 曾小明. 县级医院急性缺血性卒中超时间窗经MRI筛选溶栓的病例对照研究 [J]. 中国卒中杂志, 2022, 17(12): 1321-1326.
[2]	伊珞, 周宏宇, 仇鑫, 李子孝, 王拥军. 动脉粥样硬化性疾病的DNA甲基化改变[J]. 中国卒中杂志, 2022, 17(11): 1163-1170.
[3]	索阅, 张喆, 谢雪微, 孔庆乐, 王拥军, 荆京. 7.0T MRI在脑血管病中的应用进展[J]. 中国卒中杂志, 2022, 17(11): 1257-1263.
[4]	陈扬, 张婧, 陈芬, 丁杏, 陈昆涛. 卒中缺血性半暗带功能磁共振成像评估的研究进展[J]. 中国卒中杂志, 2022, 17(11): 1264-1270.
[5]	向薇, 徐璐瑶, 张曼曼, 魏红春, 梁志刚. 缺血性卒中急性期磁敏感加权成像不对称突出静脉征的发生率及影响因素分析[J]. 中国卒中杂志, 2022, 17(10): 1097-1102.
[6]	刘伊桐, 黄燕琪, 李明利, 冯逢, 高山, 徐蔚海. 颈动脉几何形态——60岁及以下无高危因素人群颅内动脉粥样硬化的潜在预测指标[J]. 中国卒中杂志, 2022, 17(09): 925-931.
[7]	司倩倩, 李明利, 柳青, 徐蔚海. 青年颅内动脉狭窄合并维生素B₁₂缺乏相关的偏侧不自主运动1例报道[J]. 中国卒中杂志, 2022, 17(09): 944-949.
[8]	王李, 李振水, 吴俊, 许英霞, 郝春满. 接受围手术期标准加速康复管理的颅内动脉瘤患者营养状态与显微外科夹闭术后并发症关系研究[J]. 中国卒中杂志, 2022, 17(09): 966-971.
[9]	简晓莉, 邓肖, 白雪. 延髓最后区综合征合并急性脑干综合征发病的视神经脊髓炎谱系疾病1例报道[J]. 中国卒中杂志, 2022, 17(09): 1007-1010.
[10]	徐璐瑶, 陈晓迪, 梁志刚. 卒中后失语的影像学评估研究进展[J]. 中国卒中杂志, 2022, 17(09): 1017-1021.
[11]	龚宇田, 黎洁洁. IL-6和动脉粥样硬化性缺血性卒中的关系研究进展[J]. 中国卒中杂志, 2022, 17(09): 1022-1026.
[12]	雷延成, 刘著, 王进鹏, 张豪, 杨文芳, 肖顺熙, 杨慧洁, 莫海珍, 陈燕. 高海拔地区缺血性卒中患者单核细胞/HDL-C比值与脑动脉粥样硬化性狭窄的相关性 [J]. 中国卒中杂志, 2022, 17(08): 829-833.
[13]	中国卒中学会神经介入分会. 症状性颅内动脉粥样硬化性狭窄血管内治疗中国专家共识2022[J]. 中国卒中杂志, 2022, 17(08): 863-888.
[14]	张倩, 张冠一, 张佳, 陈胜云, 赵性泉. 空腹血糖对无症状颈动脉粥样硬化斑块患者认知功能的影响—— 1项针对非城镇居民的调查[J]. 中国卒中杂志, 2022, 17(07): 753-757.
[15]	刘欣, 濮月华, 闫争争, 刘嘉, 刘丽萍. 应用计算机流体力学技术评估症状性颅内动脉狭窄患者卒中复发风险的研究[J]. 中国卒中杂志, 2022, 17(06): 638-642.