轻中度血管狭窄重构模式与斑块易损性的高分辨磁共振研究

杨倩; 张杨; 黎海涛

doi:10.16016/j.1000-5404.201703066

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轻中度血管狭窄重构模式与斑块易损性的高分辨磁共振研究

临床医学 | 更新时间：2026-01-09

- 轻中度血管狭窄重构模式与斑块易损性的高分辨磁共振研究
- High-resolution magnetic resonance imaging for mild-to-moderate vessel stenosis reconstruction mode and plaque vulnerability: report of 32 cases
- 第三军医大学学报 2017年39卷第18期页码：1836-1840
- 作者机构：
  
  400038 重庆，第三军医大学西南医院放射科
- 作者简介：
  
  [ 黎海涛，E-mail: 13883818704@163.com LI Haitao, E-mail: 13883818704@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201703066
  中图分类号： R445.2;R543.4; R743.3
- 收稿：2017-03-11，
  
  修回：2017-04-27，
  
  纸质出版：2017-09-30
- 稿件说明：
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杨倩, 张杨, 黎海涛. 轻中度血管狭窄重构模式与斑块易损性的高分辨磁共振研究[J]. 第三军医大学学报, 2017,39(18):1836-1840.

Qian YANG, Yang ZHANG, Haitao LI. High-resolution magnetic resonance imaging for mild-to-moderate vessel stenosis reconstruction mode and plaque vulnerability: report of 32 cases[J]. Journal of Third Military Medical University, 2017, 39(18): 1836-1840.
杨倩, 张杨, 黎海涛. 轻中度血管狭窄重构模式与斑块易损性的高分辨磁共振研究[J]. 第三军医大学学报, 2017,39(18):1836-1840. DOI： 10.16016/j.1000-5404.201703066.

Qian YANG, Yang ZHANG, Haitao LI. High-resolution magnetic resonance imaging for mild-to-moderate vessel stenosis reconstruction mode and plaque vulnerability: report of 32 cases[J]. Journal of Third Military Medical University, 2017, 39(18): 1836-1840. DOI： 10.16016/j.1000-5404.201703066.

摘要

目的

应用高分辨磁共振成像技术评估轻中度狭窄的颈动脉血管重构模式，探讨血管重构模式与颈动脉斑块在缺血性脑卒中事件发生、发展中的关系。

方法

纳入经超声诊断颈动脉粥样硬化，且斑块≥2 mm发生急性缺血性脑梗死或短暂性脑缺血的患者32例，进行高分辨磁共振斑块成像。根据斑块的信号、表面纤维帽的完整性判定斑块的稳定情况；同时测量斑块最厚层面、远端及近端参考点的总管腔、管壁面积，计算出管壁标准化指数、重构指数(remodeling index，RI)、斑块负荷及斑块大小。RI≥1.05为正性重构(positive remodeling，PR)，RI < 1.05为非正性重构(non-positive remodeling，non-PR)。比较PR组与Non-PR组测量指标的差异，并对重构模式与斑块易损性进行相关性分析。

结果

共检出55个颈动脉斑块

PR组与Non-PR组在总管腔、管壁面积、管壁标准化指数上差异无统计学意义(

0.05)，两组斑块负荷及斑块大小差异有统计学意义(

0.001)。重构模式与斑块易损性的相关性分析差异无统计学意义(χ

=0.532，

0.05)。

结论

轻中度血管狭窄早期以PR为主，重构模式与斑块的易损性无正性相关，斑块自身成分的变化是导致缺血性脑卒中事件发生至关重要因素。

Abstract

Objective

To evaluate artery reconstruction mode for mild-to-moderate stenosis of carotid by high resolution magnetic resonance imaging (HR-MRI)

and explore the relationship of vascular reconstruction mode with carotid artery plaque in the occurrence and development of ischemic cerebral stroke events.

Methods

Thirty-two patients with transient ischemic attack or ischemic stroke admitted in our hospital from December 2015 to December 2016 were enrolled in this study. They all had ultrasonic diagnostic hints of carotid artery atherosclerosis

plague size ≥2 mm

and acute ischemic cerebral infarction and transient ischemic attack

and were scanned with high resolution magnetic resonance imaging. According to the signal intensity of the plaques and surface integrity of fiber cap

the plaque stability was assessed

and the thickest point of reference for the distal and proximal main chamber

total vessel area

lumen area were simultaneously measured. Normal wall index

remodeling index (RI)

plaque burden and plague size were calculated. RI≥1.05 was defined as positive remodeling (PR)

and RI

1.05 as non-positive remodeling (non-PR). Independent sample

-test was used to compare the differences in measured data between PR group and non-PR group.

Chi

-square test was performed to explore the correlation between remodeling patterns and plaque vulnerability.

Results

Fifty-five carotid plaques were found by HR-MRI. There were no statistically significant differences in the total vessel area

lumen area and normal wall index between PR and non-PR group (All

0.05).The differences in plague burden and plague size were statistically significant (

0.001). There was no statistically significant correlation between the reconstruction mode and plague vulnerability (

Chi

square=0.532

0.05).

Conclusion

PR makes a point in mild-to-moderate early vascular stenosis. Remodeling mode has no positive correlation with plaque vulnerability. And the change of plaque composition is essential factor of ischemic stroke event.

关键词

Keywords

references

ZHANG S, HATSUKAMI T S, POLISSAR N L, et al. Comparison of carotid vessel wall area measurements using three different contrast-weighted black blood MR imaging techniques[J]. Magn Reson Imaging, 2001, 19(6):795-802. DOI: 10.1016/s0730-725x(01)00408-8.

N RENBERG D, EBERSBERGER H U, DIEDERICHS G, et al. Molecular magnetic resonance imaging of atherosclerotic vessel wall disease[J]. Eur Radiol, 2016, 26(3): 910-920. DOI: 10.1007/s00330-015-3881-2.

宋昌鹏, 王德昭, 胡宏宇, 等. 3.0T高分辨率磁共振评价冠状动脉粥样硬化患者的颈动脉斑块特征[J].中华心血管病杂志, 2016, 44(1): 38-42. DOI: 10.3760/cma.j.issn. 0253-3758.2016.01.009.

SONG C P, WANG D Z, HU H Y, et al. Carotid plaque characteristics detected with 3.0T high resolution nuclear magnetic resonance imaging in patients with coronary artery disease[J]. Chin J Cardiovasc, 2016, 44(1): 38-42. DOI: 10.3760/cma.j.issn.0253-3758.2016.01.009.

MA N, JIANG W J, LOU X, et al. Arterial remodeling of advanced basilar atherosclerosis: a 3-tesla MRI study[J]. Neurology, 2010, 75(3):253-258. DOI: 10.1212/WNL. 0b013e3181e8e714.

QIAO Y, ANWAR Z, INTRAPIROMKUL J, et al. Patterns and Implications of Intracranial Arterial Remodeling in Stroke Patients[J]. Stroke, 2016, 47(2): 434-440. DOI: 10.1161/STROKEAHA.115.009955.

WANG Z, HU S, SANG S, et al. Age-Period-Cohort Analysis of Stroke Mortality in China: Data From the Global Burden of Disease Study 2013[J]. Stroke, 2017, 48(2): 271-275. DOI: 10.1161/STROKEAHA.116.015031.

HEDNA V S, BODHIT A N, ANSARI S, et al. Hemispheric Differences in Ischemic Stroke: Is Left-Hemisphere Stroke More Common?[J]. Journal of Clinical Neurology, 2013, 9(2): 97-102. DOI: 10.3988/jcn.2013.9.2.97

STR MBERG S, NORDANSTIG A, BENTZEL T, et al. Risk of early recurrent stroke in symptomatic carotid stenosis[J]. Eur J Vasc Endovasc Surg, 2015, 61(2): 137-144. DOI: 10.1016/j.ejvs.2014.11.004.

LEE W J, CHOI H S, JANG J, et al. Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study[J]. Neuroradiology, 2015, 57(10): 1007-1013. DOI: 10.1007/s00234-015-1566-9.

VARNAVA A M, MILLS P G, DAVIES M J. Relationship between coronary artery remodeling and plaque vulnerability[J]. Circulation, 2002, 105(8): 939-943.DOI:10.1161/hc0802. 104327.

CHUNG J W, BANG O Y, LEE M J, et al. Echoing Plaque Activity of the Coronary and Intracranial Arteries in Patients With Stroke[J]. Stroke, 2016, 47(6): 1527-1533. DOI: 10.1161/STROKEAHA.116.013122.

PHAM T A, HUA N, PHINIKARIDOU A, et al. Early in vivo discrimination of vulnerable atherosclerotic plaques that disrupt: A serial MRI study[J]. Atherosclerosis, 2016, 244: 101-107. DOI: 10.1016/j.atherosclerosis.2015.11.013.

SUN J, LIU J, BALU N, et al. Dynamic changes in MR signals of intraplague hemorrhage are strongly correlated with plaque progression: A serial imaging study on carotid atherosclerosis[J]. Atherosclerosis, 2016, 252: e255. DOI: 10.1016/j.atherosclerosis.2016.07.072.

SUN J, LIU J, BALU N, et al. Intraplaque Hemorrhage-induced Atherosclerotic Plaque Progression as the Bridge Between Intact and Ulcerated Plaques: An Imaging-based Natural History Study[J]. Cortex, 2015, 29(1): 161-166.

ZHAO X, UNDERHILL H R, ZHAO Q, et al. Discriminating carotid atherosclerotic lesion severity by luminal stenosis and plaque burden: a comparison utilizing high-resolution magnetic resonance imaging at 3.0 Tesla[J]. Stroke, 2011, 42(2): 347-353. DOI: 10.1161/STROKEAHA.110.597328.

SAAM T, SCHOENBERG S O, HATSUKAMI T S, et al. High-resolution magnetic resonance imaging of carotid atherosclerotic plaque[J].Rofo, 2008, 180(2): 100-111. DOI: 10.1055/s-2007-963666.

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