CAJ | 학술논문

目的探讨在3.0T高场磁共振(MR)下,利用自制的血管内磁共振成像无环线圈(intravascular loopless monopole antenna,ILMA)高分辨成像小型猪腹主动脉及双侧髂动脉粥样硬化斑块的可行性.方法小型猪6只,采用动脉内膜拉伤并辅以高脂饲料的方法建立动脉粥样硬化(AS)模型.采用自制的ILMA行腹主动脉及双侧髂总动脉MR检查,检查序列包括T1加权像(DIR-T1WI)、T2加权像(FSE-T2WI)等多序列扫描.对获得的同层面图像进行分析,手动描绘血管的内外膜,计算血管内径及外径的横截面积、管壁横截面大小.最后,处死动物行组织病理学检查,以该结果为参考标准,分析ILMA检测斑块性质及成分的准确性.结果 6只小型猪的AS模型均成功建立.ILMA技术在测量血管横截面积、管腔横截而积和管壁横截面积方面均与病理学检测结果有很好的一致性(r =0.98、0.95和0.96,P＜0.001).在检测AS斑块成分方面,ILMA检测脂质成分的敏感度为77％、特异度为69％,纤维成分的敏感度为78％、特异度为73％,,k值分别为0.75 ±0.19和0.78±0.18(P ＜0.01).ILMA检测钙化成分的敏感度和特异度均为100％.ILMA测量的腹主动脉血管平均横截面积为124.08 mm2,管腔平均横截面积为49.72 mm2,管壁平均面积为74.37 mm2,病理结果比较,ILMA轻度高估以上指标.结论应用改良的ILMA可成功对AS斑块进行成像,在描绘AS斑块大小、管壁横截面积等指标及检测斑块性质和成分等方面与病理检测有较好的一致性.
목적 탐토재3.0T고장자공진(MR)하,이용자제적혈관내자공진성상무배선권(intravascular loopless monopole antenna,ILMA)고분변성상소형저복주동맥급쌍측가동맥죽양경화반괴적가행성.방법 소형저6지,채용동맥내막랍상병보이고지사료적방법건립동맥죽양경화(AS)모형.채용자제적ILMA행복주동맥급쌍측가총동맥MR검사,검사서렬포괄T1가권상(DIR-T1WI)、T2가권상(FSE-T2WI)등다서렬소묘.대획득적동층면도상진행분석,수동묘회혈관적내외막,계산혈관내경급외경적횡절면적、관벽횡절면대소.최후,처사동물행조직병이학검사,이해결과위삼고표준,분석ILMA검측반괴성질급성분적준학성.결과 6지소형저적AS모형균성공건립.ILMA기술재측량혈관횡절면적、관강횡절이적화관벽횡절면적방면균여병이학검측결과유흔호적일치성(r =0.98、0.95화0.96,P＜0.001).재검측AS반괴성분방면,ILMA검측지질성분적민감도위77％、특이도위69％,섬유성분적민감도위78％、특이도위73％,,k치분별위0.75 ±0.19화0.78±0.18(P ＜0.01).ILMA검측개화성분적민감도화특이도균위100％.ILMA측량적복주동맥혈관평균횡절면적위124.08 mm2,관강평균횡절면적위49.72 mm2,관벽평균면적위74.37 mm2,병리결과비교,ILMA경도고고이상지표.결론 응용개량적ILMA가성공대AS반괴진행성상,재묘회AS반괴대소、관벽횡절면적등지표급검측반괴성질화성분등방면여병리검측유교호적일치성.
Objective To investigate the feasibility of using intravascular loopless monopole antenna (ILMA) to image atherosclerosis plaque in a porcine model with 3.0T magnetic resonance imaging (MRI).Methods Atherosclerosis model was established by feeding high fat diet combined with balloon catheter injury to the endothelium in 6 pigs.After 3 months,animals underwent MRI and ILMA examination.The ILMA was invasively inserted to the distal part of abdominal vein and bilateral common iliac veins.MR sequences including T1 weighted imaging (T1WI),T2WI were obtained.MR image data were transferred to post-processing station.Luminal border and external elastic membrane of the vessel were reconstructed based on the MR images.After co-register these images,vessel area,lumen area,vessel wall area and plaque burden in the same lesions imaged by different modality were calculated and compared.Finally,all animals were scarified and hematoxylin eosin (HE) staining was performed in the targeted vessels.Diagnostic accuracy of MR in delineating vessel wall and detecting plaque were analyzed and calculated by comparing with pathological results.Results The atherosclerotic model was successfully established in all 6 pigs.Good agreement of delineating vessel area,lumen area vessel,wall area and plaque burden were found between MRI and pathology with r value of 0.98,0.95,and 0.96,respectively (P ＜ 0.001).Compared with pathological findings,the plaque component in corresponding area imaged by MR was as follows:sensitivity and specificity of detecting lipid plaque were 77％ and 69％,kappa value was 0.75 ± 0.19 (P ＜ 0.01) ; sensitivity and specificity on detecting fibrotic plaque were 78％ and 73％,κ value was 0.78 ± 0.18 (P ＜0.01).The sensitivity and specificity of detecting calcified plaque were 100％.ILMA results showed that the average lumen area was 49.72 mm2,average vessel area was 124.08 mm2,and the average vessel wall area was 74.37 mm2,ILMA slightly overestimated these indexes as compared with pathological results.Conclusion The results showed that ILMA could be used to image deepened artery and atherosclerotic plaque.Detected plaque size,vessel area,lumen area vessel,wall area,and plaque burden were comparable to pathological findings.It may thus provide an alternative method for detecting atherosclerotic plaque in future research work.