【摘要】 目的探讨高分辨磁共振成像(HR-MRI)技术(含3D T1-VISTA)对2型糖尿病(T2DM)合并缺血性脑卒中患者颅内动脉管壁成像的临床应用价值。方法收集我院临床初步诊断缺血性脑卒中或短暂性脑缺血发作95例患者的高清磁共振影像资料,排除图像质量不佳以及扫描层面倾斜无法进行数据测量的病例,共计46例患者的图像纳入最终分析。将病人分为T2DM组(17例)、非T2DM组(29例),分别测量右侧大脑中动脉(MCA)、左侧MCA、基底动脉(BA)的管壁情况。结果 HR-MRI可以清晰显示颅内动脉管壁情况。MCA斑块以下壁居多;BA斑块以左侧壁最多见,其次为腹侧壁。3D T1-VISTA可明确显示小斑块存在。T2DM组和非T2DM组比较,右侧MCA的管腔面积(LA)(P=0.003)、管壁面积/管腔面积(WA/LA)比值(P=0.018)及左侧MCA的WA/LA比值(P=0.015)之差异具有统计学意义。结论 HR-MRI技术可以清楚显示T2DM并缺血性脑卒中患者颅内动脉管壁细节,能够发现动脉粥样硬化所致管壁增厚,鉴别脑梗死责任血管的斑块或血栓,可早期发现颅内血管病变。更多还原

【Abstract】 Aim To investigate the application value of high resolution magnetic resonance imaging( HR-MRI)including 3D T1-VISTA sequence for intracranial artery wall imaging in patients with type 2 diabetes mellitus( T2DM)complicated with ischemic stroke. Methods High definition magnetic resonance imaging data of 95 patients with ischemic stroke or transient ischemic attack were collected in our hospital. Some cases were excluded,because the poor image quality or scanning level tilt which might lead to unsatisfactory data measurement,and a total of 46 patients were included in the final analysis of the image data. The patients were divided into two groups: 17 cases in T2 DM group,29 cases in non-T2 DM group. The vessel wall parameters of the right middle cerebral artery( MCA),left MCA,and basilar artery( BA) were measured. Results HR-MRI could clearly show the intracranial arterial wall. MCA plaques were mostly located in the inferior wall of vessel. BA plaques were mostly located in the left wall of vessel,next to the abdominal wall. 3D T1-VISTA could clearly show the existence of small plaques. In comparison between T2 DM group and nonT2 DM group,the differences of luminal area( LA)( P = 0. 003),wall area/luminal area( WA/LA) ratio( P = 0. 018) in right MCA and WA/LA ratio( P = 0. 015) in left MCA were statistically significant. Conclusions HR-MRI can clearly show the intracranial arterial wall detail in patients with T2 DM complicated with ischemic stroke. It can find the wall thickening caused by atherosclerosis,and identify the plaque or thrombosis of responsible vessel in cerebral infarction.HR-MRI can early detect the intracranial vascular lesions.更多还原