中国卒中杂志2017，Vol.12Issue(12)：1086-1092,7.DOI:10.3969/j.issn.1673-5765.2017.12.004
高分辨率磁共振对大脑中动脉斑块与梗死灶类型关系的研究
Study on the Relationship between Middle Cerebral Artery Plaque and Infarct Type by High-resolution Magnetic Resonance Imaging
摘要
Abstract
Objective This study focused on the use of high-resolution magnetic resonance imaging (HRMRI) to analyze the relationship between the stenosis of the middle cerebral artery (MCA) atherosclerosis and the type of infarction distribution, and further explored the different types of cerebral infarction and plaque nature, remodeling rate and the possible mechanism of stroke in patients. Methods The clinical data of patients with MCA blood supplied ischemic stroke and high-resolution magnetic resonance imaging within 14 days of treatment from Nanjing Drum Tower Hospital in 2012-2016 were analyzed retrospectively. Perforating artery infarct (PAI), pial infarct (PI), border zone infarct (BZI) and mixed infarcts (PAI+PI, PAI+BZI, PI+BZI, PAI+PI+BZI) were performed on diffusion weighted imaging (DWI). The stenosis rate and remodeling rate of MCA M1 were measured on sagittal HRMRI, and the morphological indexes such as position, length and thickness were collected. The reconstruction rate of positive remodeling (PR) was more than 1.05 and negative remodeling (NR) was low than 0.95. Patients with PAI, PI, and BZI were divided into single type infarct group. Patients with PAI+PI, PAI+BZI, PI+BZ, PAI+PI+BZI were assigned to mixed type infarct group. Results A total of 51 patients with MCA stenosis ≤50% were included in the study. Among which, 32 cases were in single type infarct group and 19 cases were in mixed type infarct group. There were 22 cases of patients with PAI (68.8%), 6 patients with PI (18.7%) and 4 with BZI (12.5%), 22 patients with PR (68.8%) in single. In the mixed type infarct group, 7 were PAI+BZI (36.8%), 2 were PAI+PI (10.6%), 5 were PI+BZI (26.3%) 5 were PAI+PI+BZI (26.3%), and 17 were PR (89.5%). The degree of stenosis in the mixed type infarct group was more severe (P=0.01) and the plaque thickness was larger (P=0.001) than single type infarct group, which had significant difference. Conclusion Different degrees of middle cerebral artery stenosis had different distribution of infarction. In single type infarct group, the cerebral infarction pattern was mainly PAI, while PAI+BZI was most common in mixed. At the same time, HRMRI found that increased stenosis and plaque thickness might be associated with mixed infarction for patients with mild MCA stenosis.关键词
高分辨率磁共振/大脑中动脉狭窄/脑梗死类型/斑块Key words
High-resolution magnetic resonance imaging/Middle cerebral artery stenosis/Type of cerebral infarction/Plaque引用本文复制引用
徐曼曼,徐运,周飞,张鑫,张冰,王一峰,李敬伟..高分辨率磁共振对大脑中动脉斑块与梗死灶类型关系的研究[J].中国卒中杂志,2017,12(12):1086-1092,7.基金项目
国家自然科学基金面上项目(81571134)青年科学基金项目(81200896)江苏省博士后科研资助计划(1501077A)江苏省六大人才高峰D类资助项目(2015-WSN-084)江苏省医学重点学科(实验室) (ZDXKA2016020) （81571134）
