CAJ | 학술논문

目的应用3.0T高分辨磁共振成像(high resolution magnetic resonance imaging,HRMRI)探讨症状性大脑中动脉(middle cerebral artery,MCA)粥样硬化性狭窄的重构模式.方法2009年11月~2011年5月连续入组经数字减影血管造影证实的症状性MCA M1段动脉粥样硬化性狭窄(50%~99%)患者87例,使用3.0T磁共振扫描仪对狭窄段进行HRMRI检查,测量并计算重构指数(remodeling index,RI)(最窄处血管面积/参考血管面积).RI≤0.95为阴性重构,RI≥1.05为阳性重构,RI在0.95~1.05之间为无重构.比较阴性重构和阳性重构病变的管壁特点.结果本研究70例患者纳入最终分析,其中阴性重构29例,无重构6例,阳性重构35例.阴性重构病变的管壁面积(11.5±3.0)mm2及斑块负荷(9.5±17.3)%均小于阳性重构病变的管壁面积(16.6±4.5)mm2及斑块负荷(42.3±11.0)%,差异具有显著性(P均﹤0.001).结论 HRMRI有助于评估病变的RI,在MCA动脉粥样硬化性狭窄病变中,阴性重构同样常见,且与阳性重构病变相比,其管壁面积及斑块负荷更小.
목적응용3.0T고분변자공진성상(high resolution magnetic resonance imaging,HRMRI)탐토증상성대뇌중동맥(middle cerebral artery,MCA)죽양경화성협착적중구모식.방법2009년11월~2011년5월련속입조경수자감영혈관조영증실적증상성MCA M1단동맥죽양경화성협착(50%~99%)환자87례,사용3.0T자공진소묘의대협착단진행HRMRI검사,측량병계산중구지수(remodeling index,RI)(최착처혈관면적/삼고혈관면적).RI≤0.95위음성중구,RI≥1.05위양성중구,RI재0.95~1.05지간위무중구.비교음성중구화양성중구병변적관벽특점.결과본연구70례환자납입최종분석,기중음성중구29례,무중구6례,양성중구35례.음성중구병변적관벽면적(11.5±3.0)mm2급반괴부하(9.5±17.3)%균소우양성중구병변적관벽면적(16.6±4.5)mm2급반괴부하(42.3±11.0)%,차이구유현저성(P균﹤0.001).결론 HRMRI유조우평고병변적RI,재MCA동맥죽양경화성협착병변중,음성중구동양상견,차여양성중구병변상비,기관벽면적급반괴부하경소.
Objective To investigate the remodeling pattern of symptomatic atherosclerotic middle cerebral artery(MCA) stenosis with 3.0T high-resolution magnetic resonance imaging(HRMRI). Methods Eighty-seven consecutive patients with symptomatic atherosclerotic stenoses at M1 segment of MCA on digital subtraction angiography(DSA)(50%-99%) were enrolled from November 2009 to May 2011. HRMRI was performed on the target segment by using a 3.0T MR scanner. Remodeling index(RI) was calculated as vessel area at maximal lumen narrowing(MLN)/reference vessel area. RI≤0.95 was defined as negative remodeling(NR), RI≥1.05 as positive remodeling(PR), and 0.95>RI<1.05 as intermediate remodeling(IR). Wall characteristics were compared between the NR and PR group. Results Seventy patients were included in the final analysis, and NR was found in 29(41.4%) patients, IR in 6(8.6%) patients, and PR in 35(50.0%) patients. At MLN sites, compared with lesions with PR, lesions with NR had a less wall area([11.5±3.0]mm2 vs [16.6±4.5]mm2, P﹤0.001), and percent plaque burden([9.5±17.3]%vs [42.3±11.0]%, P﹤0.001). Conclusion HRMRI can help assess the remodeling pattern of MCA stenosis. In patients with MCA atherosclerotic stenosis, NR lesions are also frequently observed and have a less wall area and plaque burden than PR lesions.