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目的:通过3.0T MRI评价颈动脉粥样硬化不稳定性斑块的成分及其分布的特点。方法:对37例经超声诊断颈动脉中重度狭窄患者进行3.0T MRI检查,分析斑块高分辨MR图像,根据斑块表面纤维帽的完整性判定斑块不稳定情况,定量测量管腔、管壁、斑块成分的面积比例、纵向长度,并计算总管腔面积、血管负荷指数、偏心指数。结果:3.0T MRI共发现15例不稳定性斑块(不稳定性斑块组)。不稳定性斑块组和稳定性斑块组在血管纵向分布上大面积脂质核心长度分别为7mm、0mm;血管负荷指数中位数分别为0.69、0.58;斑块内出血的发生率分别为82.1%和41.7%;差异均有统计学意义(P<0.05)。不稳定性斑块组偏心分布更明显,狭窄范围更长。平均管腔面积为23.87 mm2、30.16mm2,偏心指数分别为3.65、2.79,差异均有统学意义(P<0.05)。结论:不稳定性斑块在纵向及血管横断面分布上具有明显的特点,3.0T MRI可评价颈动脉粥样硬化不稳定性斑块的成分及分布特点。
OBJECTIVE: To evaluate the composition and distribution of unstable plaques in carotid atherosclerosis by 3.0T MRI. Methods: Thirty-seven patients with moderate to severe carotid stenosis underwent 3.0T MRI examination and high resolution MR images were analyzed. The instability of plaque was determined according to the integrity of the fibrous cap on the surface of the plaque. Wall, plaque composition area ratio, longitudinal length, and calculate the total luminal area, vascular load index, eccentric index. Results: A total of 15 unstable plaques (unstable plaque group) were detected by 3.0T MRI. In the unstable plaque group and the stable plaque group, the large-area lipid core length in the longitudinal distribution of the blood vessels was 7 mm and 0 mm, respectively; and the median of the vascular load index was 0.69 and 0.58 respectively. The incidence of plaque hemorrhage was 82.1 % And 41.7%, respectively (all P <0.05). Eccentric distribution of unstable plaque group more obvious, longer range of stenosis. The mean lumen area was 23.87 mm2, 30.16 mm2, and eccentricity index was 3.65 and 2.79, respectively. All the differences were significant (P <0.05). CONCLUSION: The unstable plaques have obvious characteristics in longitudinal and transverse distribution of blood vessels. The composition and distribution of unstable plaques in carotid atherosclerosis can be evaluated by 3.0T MRI.