神经损伤与功能重建2025，Vol.20Issue(6)：326-329,4.DOI:10.16780/j.cnki.sjssgncj.20250042
大脑中动脉粥样硬化性中重度狭窄斑块内出血及临床相关性分析
Analysis of Intraplaque Hemorrhage and Clinical Correlation in Patients with Moderate to Severe Stenosis of the Middle Cerebral Artery Due to Atherosclerosis
姜彬 1张拥波 1刘奇 1陈瑞玲 1高冉 1朱先进1
作者信息
- 1. 首都医科大学附属北京友谊医院神经内科 北京 100050
- 折叠
摘要
Abstract
Objective:To evaluate the proportion of intraplaque hemorrhage(IPH)and its clinical correlation in patients with atherosclerotic stenosis of the middle cerebral artery(MCA)using high-resolution magnetic resonance vessel wall imaging(HRMR-VWI).Methods:We collected clinical and imaging data from patients with moderate to severe stenosis(50％～99％)of the MCA-M1 or M2 segments treated in our hospital from July 2019 to August 2023.IPH was defined as T1 hyperintensity on fat-saturated HRMR-VWI images,with signal intensity＞150％of the surrounding muscle tissue.Patients were divided into symptomatic stenosis and asymptomatic stenosis groups based on the presence of ischemic symptoms within the MCA territory within 3 months.The symptomatic stenosis group was further subdivided into artery-to-artery embolism and non-artery-to-artery embolism subgroups according to DWI characteristics.Clinical and imaging data were compared among groups and subgroups.Results:A total of 59 patients were included in the analysis,of whom 14(23.7％)had IPH in the MCA stenosis lesions.The symptomatic stenosis group comprised 30 patients(50.8％),and the incidence of IPH in symptomatic stenosis patients was 11/30(36.7％),significantly higher than that in asymptomatic stenosis patients[3/29(10.3％)],with a statistically significant difference(P=0.018).Among symptomatic stenosis patients,11(36.7％)had artery-to-artery embolism,of whom 7/11(63.6％)had IPH,a significantly higher incidence than in non-artery-to-artery embolism patients(4/19,21.1％),with a statistically significant difference(P=0.047).No significant differences were observed for other factors between the two groups and two subgroups(all P＞0.05).Conclusion:The proportion of IPH is higher in symptomatic MCA moderate to severe stenosis patients compared to asymptomatic patients.Moreover,within the symptomatic group,patients with embolic infarction have a higher incidence of IPH.This finding is significant for evaluating the infarction mechanism and stroke risk in MCA stenosis patients.关键词
大脑中动脉/斑块/高分辨磁共振管壁成像Key words
middle cerebral artery/plaque/high resolution magnetic resonance vessel wall imaging分类
临床医学引用本文复制引用
姜彬,张拥波,刘奇,陈瑞玲,高冉,朱先进..大脑中动脉粥样硬化性中重度狭窄斑块内出血及临床相关性分析[J].神经损伤与功能重建,2025,20(6):326-329,4.
