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3T高分辨MR对颈动脉粥样硬化斑块表面钙化与斑块稳定性的量化分析
徐贤1,具海月1,王新江2,杨波1,蔡幼铨1,蔡剑鸣1*,张金山1,蔡剑鸣
0
(1.解放军总医院放射科,北京 100853 *2.兰州军区乌鲁木齐总医院,乌鲁木齐 830000;中国人民解放军总医院)
摘要:
目的:通过3T高分辨MR扫描,分析颈动脉斑块的表面钙化与斑块表面溃疡和斑块内出血的关系。方法:使用3T MR扫描仪对颈动脉斑块患者进行局部高分辨扫描,分析51例患者的钙化斑块。共纳入183个层面,记录每一层面的表面钙化类型(点状、弧形或大片状)、钙化部位(边缘型、中央型)、同一或相邻层面有无斑块内出血和表面溃疡,使用χ2检验分别分析钙化类型和部位与斑块内出血及表面溃疡的关系。结果:183层表面钙化斑块中,122层伴斑块内出血(66.7%),86层可见表面溃疡(47%)。按钙化类型和部位划分后,158层为点状、弧形的不规则钙化,25层为大片状钙化;142层为边缘钙化,41层为中央钙化。不规则钙化组伴斑块内出血的几率显著高于大片状钙化组(72.8% vs 28%,P<0.01);边缘钙化组较中央钙化组更易伴斑块内出血(71.1% vs 51.2%,P<0.05)。然而,不规则钙化、边缘型钙化与大片状钙化、中央型钙化比较,表面溃疡的发生率无统计学差异(P>0.05)。结论:表面钙化是斑块不稳定的重要因素之一,容易导致斑块内出血和溃疡形成;表面钙化的类型、部位对斑块的稳定性有重要影响。
关键词:  颈动脉  动脉硬化  斑块  表面钙化  磁共振成像
DOI:10.3724/SP.J.1008.2008.01483
投稿时间:2008-05-13修订日期:2008-07-13
基金项目:
Quantitative evaluation of superficial calcification and stability of carotid atherosclerotic plaque by high-resolution 3T MRI
XU Xian1,JU Hai-yue1,WANG Xin-jiang2,YANG Bo1,CAI You-quan1,CAI Jian-ming1*,ZHANG Jin-shan1,Cai Jian MING
(1.Department of Radiology,PLA General Hospital,Beijing 100853,China*2.Department of Radiology,Urumqi General Hospital,PLA Lanzhou Military Area Command,Urumqi 830000)
Abstract:
Objective:To evaluate the relationship of the shape,location of superficial calcification with surface ulcer,intraplaque hemorrhage in the atherosclerotic carotid plaque (ACP).Methods:Fifty-one patients received pre- and post-contrast high-resolution 3T MRI for ACP and a total 183 layers with superficial calcification were enrolled in our study.The shape of the superficial calcification was categorized as irregular type(dotted/arcuated) and patch type; the location of the calcification was categorized as marginal type and central type.Intraplaque hemorrhage and surface ulcer at the same or adjacent slice to the superficial calcification were identified.Chi-Square test was used to analyze the relationship of the shape,location of superficial calcification with surface ulcer and intraplaque hemorrhage.Results::We found that 122(66.7%) of the 183 slices had intraplaque hemorrhage and 86(47%)slices had surface ulcer.We also found that 158 slices had irregular type(dotted/arcuated)calcification and 142 slices had marginal calcification.Irregular superficial calcification was found more frequently with intraplaque hemorrhage than patch type (72.8% vs 28%,P<0.01).Marginal type had higher possibility of intraplaque hemorrhage than central type did (71.1% vs 51.2%,P<0.05).However,the incidence of surface ulcer was not significantly different between different types and locations of superficial calcification.Conclusion:It can be concluded that superficial calcification is an important factor for instability of atherosclerotic carotid plaque.The shape and location of superficial calcification are important factors of intraplaque hemorrhage.
Key words:  carotid artery  atherosclerosis  plaque  superficial calcification  magnetic resonance imaging