| 摘要: |
| 目的 应用高分辨率磁共振（HR-MRI）管壁成像技术研究基底动脉粥样硬化性梗死两种类型——穿支闭塞型病变（BOD）和非穿支闭塞型病变（non-BOD）的血管重构与斑块特征。方法 将32例症状性基底动脉狭窄患者分为BOD 18例，non-BOD 14例。应用3.0T HR-MRI对基底动脉进行管壁增强扫描，然后使用CMRtools软件对血管狭窄最严重的层面的管壁及斑块面积等参数进行测量，研究血管的重构和斑块特征。结果 HR-MRI管壁成像结果显示，non-BOD组血管狭窄程度较BOD组更明显[（68.9%±19.1）% vs（43.8%±18.8）%，P=0.017]。正性重构更常见于non-BOD（57.2% vs 16.7%，P=0.036）。BOD组管壁面积指数小于non-BOD组（P<0.001）。两组血管强化均以偏心性为主，两组斑块强化比例差异无统计学意义（P=0.196），但BOD组强化程度小于non-BOD组[（39.9±23.2）% vs（65.3±21.1）%，P=0.004]。结论 基底动脉BOD梗死和non-BOD型梗死在血管重构和斑块性质方面的特征各不相同。 |
| 关键词: 颅内动脉粥样硬化性卒中 高分辨率磁共振成像 基底动脉狭窄 血管重构 斑块稳定性 |
| DOI：10.16781/j.0258-879x.2016.10.1217 |
| 投稿时间：2016-04-26修订日期：2016-09-03 |
| 基金项目:上海市科委医学引导项目（124119a8900）. |
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| Vascular pathophysiologic characteristics of different types of basilar atherosclerotic infarction |
| ZHU Xuan,CHEN Lei,ZHANG Ping,ZHANG Min-min,YUAN Hui,WU Tao,DENG Ben-qiang* |
(Stroke Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To use high-resolution magnetic resonance imaging (HR-MRI) for studying the vascular remodeling and plaque characteristics of two types of basilar atherosclerotic infarction:branch occlusive disease (BOD) and non-BOD. Methods Thirty-two patients with symptomatic basilar artery stenosis were divided into BOD and non-BOD groups, with 18 patients in BOD group and 14 in non-BOD group. All the patients received 3.0T HR-MRI enhancement scanning for the basilar artery wall. The wall thickness and plaque area of steno-occlusive basilar artery at the maximal stenosis were measured and analyzed, so as to assess the vascular remodeling and plaque characteristics. Results HR-MRI scanning showed that the stenosis of non-BOD group was more obvious than that of BOD group ([68.9±19.1]% vs[43.8±18.8]%, P=0.017). Compared with BOD group, positive remodeling was more frequently observed in non-BOD (57.2% vs 16.7%, P=0.036). The wall area index of BOD group was also significantly lower than that of non-BOD group (P<0.001). Eccentric enhancement was the main form for the two types of basilar atherosclerotic infarction in study, and the plaque enhancements were not significantly different between BOD and non-BOD groups (P=0.196); however, the enhancement degree of BOD group was significantly milder than that of the non-BOD group ([39.9±23.2]% vs[65.3±21.1]%, P=0.004). Conclusion BOD and non-BOD have different vascular remodelings and plaque characteristics. |
| Key words: intracranial atherosclerotic stroke high-resolution magnetic resonance imaging basilar artery stenosis vascular remodeling plaque stability |
