3.0T高分辨磁共振研究大脑中动脉粥样硬化性狭窄重构模式

摘要/Abstract

摘要：

目的应用3.0T高分辨磁共振成像（high resolution magnetic resonance imaging，HRMRI）探讨症状性大脑中动脉（middle cerebral artery，MCA）粥样硬化性狭窄的重构模式。方法 2009年11月～2011年5月连续入组经数字减影血管造影证实的症状性MCA M1段动脉粥样硬化性狭窄（50%～99%）患者87例，使用3.0T磁共振扫描仪对狭窄段进行HRMRI检查，测量并计算重构指数（remodeling index，RI）（最窄处血管面积/参考血管面积）。RI≤0.95为阴性重构，RI≥1.05为阳性重构，RI在0.95～1.05之间为无重构。比较阴性重构和阳性重构病变的管壁特点。结果本研究70例患者纳入最终分析，其中阴性重构29例，无重构6例，阳性重构35例。阴性重构病变的管壁面积（11.5±3.0）mm2及斑块负荷（9.5±17.3）%均小于阳性重构病变的管壁面积（16.6±4.5）mm2及斑块负荷（42.3±11.0）%，差异具有显著性（P均﹤0.001）。结论 HRMRI有助于评估病变的RI，在MCA动脉粥样硬化性狭窄病变中，阴性重构同样常见，且与阳性重构病变相比，其管壁面积及斑块负荷更小。

文章导读： 高分辨磁共振管壁成像揭示了大脑中动脉的重构特点，具有临床指导意义

关键词: 动脉粥样硬化; 大脑中动脉; 重构指数; 磁共振成像; 高分辨

Abstract:

Objective To investigate the remodeling pattern of symptomatic atherosclerotic middle cerebral artery(MCA) stenosis with 3.0T high-resolution magnetic resonance imaging(HRMRI). Methods Eighty-seven consecutive patients with symptomatic atherosclerotic stenoses at M1 segment of MCA on digital subtraction angiography(DSA)(50%-99%) were enrolled from November 2009 to May 2011. HRMRI was performed on the target segment by using a 3.0T MR scanner. Remodeling index(RI) was calculated as vessel area at maximal lumen narrowing(MLN)/reference vessel area. RI≤0.95 was defined as negative remodeling(NR), RI≥1.05 as positive remodeling(PR), and 0.95＞RI＜1.05 as intermediate remodeling(IR). Wall characteristics were compared between the NR and PR group. Results Seventy patients were included in the final analysis, and NR was found in 29(41.4%) patients, IR in 6(8.6%) patients, and PR in 35(50.0%) patients. At MLN sites, compared with lesions with PR, lesions with NR had a less wall area([11.5±3.0]mm2 vs [16.6±4.5]mm2, P﹤0.001), and percent plaque burden([9.5±17.3]% vs [42.3±11.0]%, P﹤0.001). Conclusion HRMRI can help assess the remodeling pattern of MCA stenosis. In patients with MCA atherosclerotic stenosis, NR lesions are also frequently observed and have a less wall area and plaque burden than PR lesions.

Key words: Atherosclerosis, Middle cerebral artery; Remodeling index; High resolution magnetic resonance imaging

朱先进1，王春雪1，姜卫剑2，杜彬2，金旻2，娄昕3，马林3. 3.0T高分辨磁共振研究大脑中动脉粥样硬化性狭窄重构模式[J]. 中国卒中杂志, 2013, 8(03): 171-176.

ZHU Xian-Jin*, WANG Chun-Xue, JIANG Wei-Jian, DU Bin, JIN Min, LOU Xin, MA Lin.. Remodeling Pattern of Atherosclerotic Middle Cerebral Artery Stenosis on 3.0T High-Resolution Magnetic Resonance Imaging[J]. Chinese Journal of Stroke, 2013, 8(03): 171-176.

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