摘要
目的:通过计算机断层摄影动脉造影术(computed tomography arteriography,CTA)和高分辨磁共振成像(high resolution-magnetic resonance imaging,HR-MRI)两种影像检查方法评价引起缺血性脑卒中的责任血管,探讨脑梗死的发生发展与血管狭窄程度、责任斑块内出血、责任斑块的强化程度的关联性。方法:选取2018年08月至2020年12月接受常规颅脑MRI影像学检查,且影像诊断为单侧大脑中动脉(MCA)供血区急性脑梗死的患者为研究对象,分别采用CTA(CTA检查组)和HR-MRI(HR-MRI检查组)分析患者MCA粥样斑块所致管腔狭窄程度及可能的斑块组分,20例/组,其中HR-MRI组包含10例HR-MRI平扫患者和10例HR-MRI增强患者,在图像后处理工作站勾画梗死灶并测量最大层面面积,由2位副高以上诊断医师对责任血管管腔的狭窄程度、斑块成分以及斑块强化程度进行分析,采用Pearson线性相关和Spearman等级相关法评价血管狭窄程度与梗死灶面积之间的关联性,采用卡方检验分析比较不同斑块成分和不同斑块强化程度患者的梗死灶面积。结果:CTA检查组和HR-MRI检查组的责任血管狭窄程度均与梗死灶面积无相关性(P>0.05);在HR-MRI平扫组中,斑块表现为T1WI高或稍高信号,T2WI混杂信号者的梗死灶面积高于表现为其他信号者(P<0.05);在HR-MRI增强检查组,斑块高强化者的梗死灶面积大于中度强化者的梗死灶面积(P<0.05)。结论:相对于责任血管的狭窄程度,颅内动脉斑块内出血及炎症反应是决定脑梗死转归更为重要的因素。
Objective:To evaluate the responsible vessels for ischemic stroke with computed tomography arteriography(CTA)and high resolution-magnetic resonance imaging(HR-MRI),and to explore the relationship between the occurrence and development of cerebral infarction and the degree of vascular stenosis,the composition and stability of the responsible plaque.Methods:Patients who underwent routine brain MRI examination from August 2018 to December 2020 in our hospital and diagnosed with acute cerebral infarction of unilateral middle cerebral artery(MCA)territory were included in the study.CTA and HR-MRI were used to analyze the degree of lumen stenosis caused by MCA atheromatous plaque and possible plaque components,20 cases in each group(CTA group and HR-MRI group)and the HR-MRI group included 10 patients with HR-MRI plain scan(HR-MRI plain scan group,n=10)and 10 patients with contrast-enhanced HR-MRI(HR-MRI contrast-enhanced group,n=10).The image post-processing workstation was used to outline the infarction and measure the maximum sectional area,and two experienced diagnosticians analyzed the stenosis degree,plaque composition,and plaque enhancement degree of the responsible vessels.Pearson’s linear correlation and Spearman’s rank correlation were used to evaluate the relationship between the degree of vascular stenosis and infarct size.Chi-square analysis was used to compare the infarct size of patients with different plaque components and different plaque enhancement degrees.Results:There was no correlation between the degree of responsible vessel stenosis and the infarct size in either the CTA group or the HR-MRI group(P>0.05).In the HR-MRI plain scan group,the plaques showed high or slightly high signal of T1WI,and the infarct size of those with the mixed signal of T2WI was significantly higher than that of those with other signals(P<0.05).In the HR-MRI contrast-enhanced group,the infarct area of the patients with high plaque enhancement was significantly larger than that of the patients with moderate enhancement(P<0.05).Conclusion:Compared with the stenosis degree of the responsible vessel,intracranial arterial plaque hemorrhage and inflammatory response are more important prognostic factors for cerebral infarction.
作者
金涛
陈强
罗琳
JIN Tao;CHEN Qiang;LUO Lin(Department of Medical Imaging,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,China)
出处
《包头医学院学报》
CAS
2024年第7期62-67,共6页
Journal of Baotou Medical College
基金
包头医学院扬帆计划项目(BYJJ-YF-2018011)。
