短暂性脑缺血发作及急性缺血性卒中患者高分辨MRI斑块负荷差异与ABCD2评分相关性分析
Analysis of high-resolution MRI plaque burden and its correlation with ABCD2 scores in transient ischemic attack and acute ischemic stroke patients
凡娜 1陈鹏飞 1李自凯 1杨威威 1王剑 1梁奕1
作者信息
- 1. 长江航运总医院/武汉脑科医院放射科 湖北 武汉 430010
- 折叠
摘要
目的:利用3D-SPACE高分辨率磁共振成像(HR-MRI)探究短暂性脑缺血发作(TIA)患者与急性缺血性卒中(AIS)患者斑块负荷的差异及其与ABCD2评分的相关性.方法:回顾性分析78例接受HR-MRI检查的56例TIA及22例AIS患者病例,根据脑卒中风险评分量表ABCD2评分将TIA组患者分为低中危组(ABCD2＜6,37例)与高危组(ABCD2≥6,19例).测量并计算病变颈内动脉血管狭窄率、最大管壁厚度(WTmax)、最小管壁厚度(WTmin)、病变或参考层面管腔面积(LAMLN/LARL)、病变或参考层面血管总面积(TVAMLN/TVARL)、病变或参考管壁面积(WAMLN/WARL);标准化壁指数(NWI)、重构指数(RI)、偏心指数(EI).采用单因素方差分析或非参数Kruskal Wallis检验比较组间临床特征和斑块负荷的差异.采用多分类有序Logistic回归分析斑块负荷对低中危TIA组、高危TIA组、AIS组分组的影响关系.采用Spearman等级相关或Pearson相关及多重线性回归分析TIA组斑块负荷与ABCD2评分的关系.结果:AIS患者颈内动脉病变WTmax、WTmin、LAMLN、RI、NWI与低中危TIA组、高危TIA组比较,差异有统计学意义(H=9.93、9.61、27.08、6.02、29.20,均P＜0.05),其中组间比较WTmax、WTmin的差异仅低中危组与AIS组有统计学意义(P＜0.05),LAMLN、NWI组间比较低中危TIA组、高危TIA组分别与AIS组有统计学意义(P＜0.05).NWI可能是预测急性缺血性卒中发生的斑块负荷影响指标(95％CI:2.87～14.75,P=0.004).ABCD2评分的得分情况与RI(r=0.291,P=0.029)之间存在相关性.结论:本研究揭示了低中危组、高危组TIA及AIS患者的颈内动脉粥样硬化斑块特征,参数NWI与卒中及TIA分层患者存在相关性,RI与ABCD2评分存在弱正相关,是识别高风险TIA患者的潜在指标,对早期预防卒中的事件发生具有重要的临床价值.
Abstract
Objective:To investigate the differences in carotid artery plaque burden between transient ischemic attack(TIA)and acute ischemic stroke(AIS)and analyze the correlation with ABCD2 scores in TIA patients based on high-resolution MRI(HR-MRI).Methods:A total of seventy-eight patients were retrospectively collected and divided into the AIS group(22 patients)and the TIA group(56 patients).According to ABCD2 scores,a low-intermediate risk group(ABCD2 score＜6)(37 pa-tients)and a high risk group(ABCD2 score≥6)(19 patients)were included.Wall thickness,vessel area,lumen area,remodeling index(RI),eccentricity index(EI),and normalized wall index(NWI)were calculated and analyzed.Differences in clinical characteristics and plaque burden among groups were compared using the one-way analysis of variance or the Kruskal Wallis test.The relationship of plaque burden in the TIA and AIS groups was determined using ordinal logistic regression.The corre-lations of TIA plaque burden and ABCD2 score were analyzed by Spearman rank(or Pearson)correla-tion and multiple linear regression.Results:The WTmax,WTmin,LAMLN,RI,and NWI of the in-ternal carotid artery were compared between low-intermediate risk and high risk groups,and statistical significant differences were found(H=9.93,9.61,27.08,6.02,and 29.20,respectively,all P＜0.05).Significant differences were found in WTmax and WTmin only between the low-medium-risk TIA group and AIS group(P＜0.05),while LAMLN and NWI showed significant differences between both TIA groups and AIS group(P＜0.05).Conclusion:This study reveals the plaque features of the internal carotid artery in TIA and AIS patients.The parameter NWI is correlated with AIS and TIA-stratified patients,and RI has a weak positive correlation with the ABCD2 score,which is a potential indicator for TIA-stratified patients and has important significance for early prevention of stroke.
关键词
颈动脉粥样硬化/急性缺血性卒中/短暂性脑缺血发作/颈动脉高分辨成像/斑块负荷,ABCD2评分Key words
Carotid Atherosclerosis/Acute Ischemic Stroke/Transient Ischemic Attack/High Resolution Imaging/Plaque Burden,ABCD2 Score引用本文复制引用
基金项目
武汉市卫生健康委医学科研基金项目(WX20C17)
出版年
2024
NETL
NSTL
万方数据