高分辨率磁共振成像管壁成像技术在颅内动脉粥样硬化斑块中的诊断价值

Application of high resolution magnetic resonance imaging tube wall imaging technology in the diagnosis of intracranial atherosclerotic plaque

  • 摘要:
      目的  探讨高分辨率磁共振成像(MRI)管壁成像技术在颅内动脉粥样硬化斑块中的诊断价值。
      方法  回顾性分析213例颅内动脉粥样硬化斑块病变患者的诊疗情况。按照疾病状况,分为急性脑梗死组与短暂性脑缺血发作(TIA)组。比较2组患者斑块分布情况、血管重构方式,对各项检验指标进行受试者工作特征曲线(ROC)分析。
      结果  急性脑梗死组患者腹侧壁、上侧壁斑块分布人数比例显著高于TIA组(P < 0.05)。急性脑梗死组患者背侧壁、下侧壁斑块分布人数比例显著低于TIA组患者(P < 0.05)。急性脑梗死组患者血管正性重构比例显著高于TIA组患者(P < 0.05), 负性重构及无重构比例显著低于TIA组(P < 0.05)。在急性脑梗死诊断方面,斑块负荷百分比、狭窄率、斑块面积(PA)、管腔最窄处血管面积(WAMLN)及管腔最窄处管腔面积(LAMLN)均有一定准确性与敏感性,其中WAMLN有着最优的诊断能力,最优截止数值为9.50 mm2, 特异性与灵敏度分别为63.00%与86.70%。
      结论  高分辨率MRI管壁成像技术在颅内动脉粥样硬化斑块诊断中有较高的价值。

     

    Abstract:
      Objective  To explore the value of high resolution magnetic resonance imaging (MRI) tube wall imaging technology in the diagnosis of intracranial atherosclerotic plaque.
      Methods  The diagnosis and treatment of 213 patients with intracranial atherosclerotic plaque were analyzed retrospectively. According to the disease status, they were divided into acute cerebral infarction group and transient ischemic attack (TIA) group. The plaque distribution and vascular remodeling of the two groups were compared, and receiver operating curve (ROC) of each index was analyzed.
      Results  The ratio of patients with distribution of plaques in the abdominal wall and upper wall in acute cerebral infarction group was significantly higher than that in TIA group (P < 0.05). The ratio of patients with plaque distribution in the dorsal and inferior wall in acute cerebral infarction group was significantly lower than that in TIA group (P < 0.05). The positive rate of vascular remodeling in the acute cerebral infarction group was significantly higher than that in the TIA group (P < 0.05), and the negative and non-remodeling rates were significantly lower than those in the TIA group (P < 0.05). In the diagnosis of acute cerebral infarction, the percentage of plaque load, the rate of stenosis, the area of plaque (PA), the area of vessel at the narrowest lumen (WAMLN) and the area of lumen at the narrowest lumen (LAMLN) showed certain accuracy and sensitivity in diagnosis, and WAMLN showed the best diagnosis ability, with the best cut-off value of 9.50 mm2, and the specificity and sensitivity were 63.00% and 86.70% respectively.
      Conclusion  High resolution MRI tube wall imaging technology has a high value in the diagnosis of intracranial atherosclerotic plaque.

     

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