颈动脉斑块MRI特征与同侧急性脑梗死患者DWI-ASPECTS的相关性研究
Correlation of carotid plaque characteristics with DWI-ASPECTS score in ipsilateral acute cerebral in-farction patients
王贝茹 1余苗 1徐彤彤 1李均彪 2胡春峰1
作者信息
- 1. 221000 江苏,徐州医科大学附属医院影像科
- 2. 221000 江苏,徐州医科大学附属医院介入科
- 折叠
摘要
目的:探讨颈动脉斑块 MRI 特征与同侧急性脑梗死患者 DWI-ASPECTS 的相关性.方法:回顾性搜集我院 85 例颈动脉斑块患者的临床及影像资料,所有患者均于出现脑血管症状 2 周内行颈动脉高分辨率 MRI 和常规颅脑 MRI 平扫.将患者分为 DWI-ASPECTS≤7 分组和 DWI-AS-PECTS＞7 分组,比较两组间临床、实验室资料和颈动脉斑块定量、定性指标的差异.通过 Logistic 回归筛选DWI-ASPECTS评分的预测因子.结果:25 例(29.4%)DWI-ASPECTS≤7 分,60 例(70.6%)DWI-ASPECTS＞7 分.DWI-ASPECTS≤7 分组患者纤维帽变薄/破裂(分别为 80.0%和 35.0%,P＜0.001)、斑块内出血(分别为 72.0%和 21.7%,P＜0.001)、钙化(分别为 76.0%和 45.0%,P＝0.009)和富脂质坏死核心(分别为 72.0%和 45.0%,P＝0.023)的发生率均高于 DWI-ASPECTS＞7 分组;此外,DWI-ASPECTS≤7 分组患者显示出更高的斑块负荷,DWI-ASPECTS≤7 分组与 DWI-ASPECTS＞7分组的最大管壁厚度[分别为(4.38±1.68)和(3.47±1.78)mm,P＝0.033]、平均管腔面积[分别为(15.33±11.57)和(22.88±13.95)mm2,P＝0.019]、最小管腔面积[分别为(11.52±11.23)和(18.98±13.52)mm2,P＝0.017]、平均管壁面积[分别为(62.81±14.32)、(55.66±14.93)mm2,P＝0.045]、最大管壁面积[分别为(66.70±14.57)、(59.56±15.19)mm2,P＝0.049]、平均标准化管壁面指数[分别为(81±14)%、(71±16)%,P＝0.011]、最大标准化管壁指数[分别为(86±14)%、(76±16)%,P＝0.012)]差异均有统计学意义.DWI-ASPECTS≤7 分组中NIHSS评分＞4 分的患者比例更高(分别为48%和 23.3%,P＝0.025),高密度脂蛋白浓度更低[分别为(1.24±0.28)、(1.10±0.28)mmol/L,P＝0.043].Logistic回归分析结果显示,纤维帽变薄/破裂(OR＝4.133,95%CI:1.151～14.836,P＝0.030)和斑块内出血(OR＝6.409,95%CI:1.737～23.646,P＝0.005)与较低的 DWI-ASPECTS 评分显著相关.结论:颈动脉斑块中存在纤维帽变薄/破裂和斑块内出血的急性脑卒中患者 DWI-ASPECTS 评分更低,有助于评估患者的病情严重程度.
Abstract
Objective:To analyze the correlation between carotid plaque characteristics and DWI-ASPECTS score in patients with ipsilateral acute cerebral infarction.Methods:The clinical and imaging data of 85 patients with carotid plaque in our hospital were retrospectively analyzed.All patients under-went carotid high resolution MRI and conventional brain MR plain scan within 2 weeks after the onset of cerebrovascular symptoms.Patients were divided into DWI-ASPECTS≤7 and DWI-ASPECTS＞7 groups.The clinical,laboratory,and the quantitative and qualitative parameters of the carotid plaque were compared between groups.The predictors of DWI-ASPECTS score were screened by Logistic re-gression.Results:Of the 85 patients,25(29.4%)was DWI-ASPECTS≤7 and 60(70.6%)was DWI-ASPECTS＞7.Compared with DWI-ASPECTS＞7 group,incidence of TRFC(80%vs 35%,P＜0.001),IPH(72%vs 21.7%,P＜0.001),CA(76%vs 45%,P＝0.009)and LRNC(72%vs 45%,P＝0.023)were significantly increased in DWI-ASPECTS≤7 group.In addition,DWI-ASPECTS≤7 group showed higher plaque burden than that of DWI-ASPECTS＞7 group[maxWT(4.38±1.68)mm vs(3.47±1.78)mm,P＝0.033),meanLA(15.33±11.57)mm2 vs(22.88±13.95)mm2,P＝0.019),min-LA(11.52±11.23)mm2 vs(18.98±13.52)mm2,P＝0.017),meanWA(62.81±14.32)mm2 vs(55.66±14.93)mm2,P＝0.045),maxWA(66.70±14.57)mm2 vs(59.56±15.19)mm2,P＝0.049),mean NWI(81±)14%vs(71±16)%,P＝0.011),max NWI(86±14)%vs(76±16)%,P＝0.012)]and higher NIHSS(48%vs 23.3%,P＝0.025),while HDL was higher in DWI-ASPECTS＞7 group[(1.24±0.28)mmol/L vs(1.10±0.28)mmol/L,P＝0.043].Binary Logistic regression analysis showed that TRFC(OR＝4.133,95%CI:1.151～14.836,P＝0.030)and IPH(OR＝6.409,95%CI 1.737～23.646,P＝0.005)were risk predictors of DWI-ASPECTS≤7.Conclusion:TRFC and IPH presented in carotid plaque were significantly associated with lower DWI-ASPECTS scores,which help to assess the severity of the ACI patients.
关键词
颈动脉斑块/磁共振成像/DWI-ASPECTS评分/急性脑梗死Key words
Carotid plaque/Magnetic resolution imaging/DWI-ASPECTS score/Acute cere-bral infarction引用本文复制引用
出版年
2024
NETL
NSTL
万方数据