基于HR-MRI观察患者颅内血管斑块特征与患者预后的关系

doi:10.7517/issn.1674-0475.220203

摘要/Abstract

摘要： 本研究探讨高分辨率磁共振成像（HR-MRI）评估急性缺血性脑梗死（AIS）患者大脑中动脉（MCA）、基底动脉（BA）斑块特征及与患者预后的关系。选取存在MCA或BA狭窄的114例AIS患者作为研究对象进行回顾性研究，所有患者术前均接受了MRI及HR-MRI检查，根据患者预后结局分为良好组（73例）和不良组（41例）；对比分析两组患者MCA、BA的斑块参数的差异；采用Logistic多因素模型分析斑块特征及各种因素与AIS患者预后的关系。不良组患者颅内血管斑块符合值、非正性重塑率、斑块信号呈明显强化特征、斑块内出血患者占比均高于良好组，差异具有统计学意义（P<0.05）；斑块负荷预测AIS患者不良结局的曲线下面积（AUC）值为0.690、灵敏度为78.95%、特异度为57.29%；血管重塑模式、斑块信号呈明显强化特征、斑块内出血三项因素预测患者不良结局的AUC值分别为0.535、0.662、0.645，灵敏度分别为65.85%、70.73%、53.66%，特异度分别为58.90%、61.64%、75.34%。影响AIS患者的因素较多，颅内血管斑块特征与患者预后结局关系密切，通过HR-MRI观察患者颅内血管斑块特征对于评估患者预后方面具有一定的参考价值。

关键词: 高分辨率磁共振成像, 急性缺血性脑梗死, 大脑中动脉, 基底动脉, 斑块特征, 血管重塑

Abstract: This study explored the relationship between middle cerebral artery (MCA) and basilar artery (BA) plaque characteristics and patients prognosis with acute ischemic stroke (AIS) assessed by high resolution magnetic resonance imaging (HR-MRI). Chosen 114 AIS patients with MCA or BA stenosis as research objects to conduct the retrospective study, and all patients received MRI and HR-MRI examinations before surgery. According to the prognostic outcome, the patients were divided into the good group with 73 cases and the poor group with 41 cases. Compared and analyzed the differences of MCA and BA plaque parameters between the two groups, and analyzed the plaque characteristics and the relationship between various factors and the prognosis of AIS patients through the logistic multivariate model. In the poor group, the coincidence value of intracranial vascular plaque, the non-positive remodeling rate, the obvious enhancement of plaque signal, and the proportion of patients with intra-plaque hemorrhage were higher than those in the good group, and the difference was statistically significant (P<0.05). The area under the curve (AUC)value of block load predicting the adverse outcome of AIS patients was 0.690, the sensitivity was 78.95%, and the specificity was 57.29%; the three factors of vascular remodeling pattern, plaque signal showing obvious enhancement characteristics, and intraplaque hemorrhage predict the AUC value of the adverse outcome of patients were 0.535, 0.662, 0.645, the sensitivity was 65.85%, 70.73%, 53.66%, and the specificity was 58.90%, 61.64%, 75.34%, respectively. There are many factors which affect AIS patients, the characteristics of intracranial vascular plaques are closely related to the patient prognosis. Observing the characteristics of intracranial plaques through HR-MRI has a certain reference value for evaluating the prognosis of patients.

Key words: high resolution magnetic resonance imaging, acute ischemic stroke, middle cerebral artery, basilar artery, plaque characteristics, vascular remodeling

杨淑殷, 王峥. 基于HR-MRI观察患者颅内血管斑块特征与患者预后的关系[J]. 影像科学与光化学, 2022, 40(4): 746-751.

YANG Shuyin, WANG Zheng. Observation of the Relationship between the Characteristics of Intracranial Vascular Plaque and Patients Prognosis Based on HR-MRI[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 746-751.

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