摘要
目的:应用高分辨磁共振血管壁成像技术（HRMR-VWI）分析颅内动脉粥样硬化（ICAS）斑块成分及特征与缺血性脑卒中的相关性。方法:对2020年12月至2021年9月期间包头市中心医院神经内科的78例ICAS性狭窄的患者行HRMR-VWI扫描。将检出的颅内斑块分为责任斑块（67个）与非责任斑块（125个），比较2组间斑块成分、特征的差异。根据有无脑梗死病史将入组患者分为急性/亚急性脑梗死组（34例）、慢性脑梗死组（18例）、无脑梗死组（26例）3组，比较3组间责任斑块成分、特征的差异。运用SPSS 21.0软件进行统计分析，通过多元Logistic回归分析斑块成分、特征与缺血性脑卒中的关系，并通过Spearman相关分析其与美国国立卫生研究院卒中量表评分（NIHSS）的相关性，显著性检验水准α=0.05。结果:责任斑块组斑块内出血（IPH）率（P＜0.001）、血栓率（P＜0.001）、明显强化率（P=0.010）、中重度血管狭窄程度（P＜0.001）和斑块负荷（P＜0.001）均显著高于非责任斑块组，差异均有统计学意义。急性/亚急性脑梗死组中责任斑块的IPH率（P=0.013）、血栓率（P=0.001）、斑块负荷（P＜0.001）均显著高于无脑梗死组，差异均有统计学意义。IPH（rs=0.348、P=0.004）、血栓（rs=0.373、P=0.002）、斑块负荷（rs=0.360、P=0.003）与NIHSS评分均呈正相关关系。结论:IPH、血栓的存在与责任斑块及同侧卒中事件密切相关。较大的斑块负荷可增加缺血性卒中事件发生的风险，且卒中的严重程度会更重、预后更差。
Abstract
Objective:To analyze the correlation between the components and characteristics of intracranial atherosclerotic plaques and ischemic stroke by high-resolution MRI vascular wall imaging (HRMR-VWI).Methods:78 patients with intracranial atherosclerotic stenosis in the Department of Neurology of Baotou Central Hospital from December 2020 to September 2021 were scanned by HRMR-VWI. The detected intracranial plaques were divided into responsible plaques (67) and non-responsible plaques (125), and the differences in plaque composition and characteristics between the two groups were compared. According to the history of cerebral infarction, the patients were divided into three groups: acute / subacute cerebral infarction group (34 cases), chronic cerebral infarction group (18 cases), and non-cerebral infarction group (26 cases). The differences in the composition and characteristics of responsible plaque among the three groups were compared. Statistical analysis was conducted using SPSS 21.0 software, and the relationship between plaque composition, characteristics, and ischemic stroke was analyzed through multiple Logistic regression. The correlation with the National Institutes of Health stroke scale (NIHSS) was analyzed through Spearman correlation, and the significance test criteria were used α=0.05.Results:In the responsible plaque group, the rate of intraplaque hemorrhage (IPH) (P＜0.001), the rate of thrombus (P＜0.001), the rate of significant enhancement (P=0.010), the rate of moderate to severe stenosis (P＜0.001), and the plaque load (P＜0.001) were significantly higher than those in the non-responsible plaque group, and the differences were statistically significant. The rate of IPH (P=0.013), the rate of thrombus (P=0.001), and the plaque load (P＜0.001) of responsible plaques in the acute/subacute cerebral infarction group were significantly higher than those in the non-cerebral infarction group, and the differences were statistically significant. IPH (rs=0.348, P=0.004), thrombus (rs=0.373, P=0.002), and plaque load (rs=0.360, P=0.003) were all positively correlated with NIHSS score.Conclusion:The presence of IPH and thrombus is closely related to responsible plaque and ipsilateral stroke. A large plaque load can increase the risk of ischemic stroke events, and the severity of stroke may be more severe and the prognosis worse.
万方数据