【摘要】 目的探讨脑血管病患者轻度狭窄或无狭窄颈动脉粥样硬化(AS)斑块的高分辨率MRI(HRMRI)特征。方法对103例近期出现脑血管病症状且伴颈动脉AS斑块的患者行颈动脉HRMRI。排除图像质量差或颈动脉严重狭窄(狭窄程度≥50%)者。对颈动脉斑块进行定性和定量分析,比较无狭窄(无狭窄组)与轻度狭窄(轻度狭窄组,狭窄程度1%~49%)颈动脉AS斑块的负荷及成分特征差异。结果最终86例患者共155支颈动脉血管纳入研究,轻度狭窄组24支,无狭窄组131支。无狭窄与轻度狭窄组颈动脉管腔面积[(53.40±15.29)mm~2 vs(41.30±11.57)mm~2,P<0.001]和最大管壁厚度[(2.16±0.90)mm vs(3.30±1.25)mm,P=0.014]差异均有统计学意义,而管壁面积[(31.69±6.80)mm~2 vs(32.80±9.33)mm~2,P=0.581]差异无统计学意义。无狭窄组和轻度狭窄组存在中度风险斑块、高风险斑块者分别占10.69%(14/131)、6.11%(8/131)和20.83%(5/24)、20.83%(5/24)。颈动脉最大管壁厚度与管腔狭窄程度之间呈正相关(r=0.430,P<0.001)。结论无狭窄或轻度狭窄的颈动脉血管仍存在发生不稳定斑块的风险。更多还原

【Abstract】 Objective To evaluate the characteristics of high resolution MRI(HRMRI)in atherosclerotic plaques of lowgrade and non-stenosis carotid arteries.Methods A total of 103 patients with recent cerebrovascular symptoms and carotid plaques were underwent carotid HRMRI.Arteries with poor image quality or severe luminal stenosis(≥50%)were excluded.MR images were reviewed for qualitative and quantitative evaluation of plaque characteristics.The plaque burden and the compositional features between carotid arteries with low-grade stenosis(1%—49%)and without stenosis were compared.Results Totally 86patients(155carotid arteries)were recruited in this study.Of all patients,155 carotid arteries including 24 with low-grade stenosis and 131 without stenosis were qualified for analysis.Statistically significant differences were found in lumen area([53.40±15.29]mm~2 vs[41.30±11.57]mm~2,P<0.001)and maximum wall thickness([2.16±0.90]mm vs[3.30±1.25]mm,P=0.014)between carotid arteries with low-grade stenosis and without stenosis.But no significant differences was found in wall area([31.69±6.80]mm~2 vs[32.80±9.33]mm~2,P=0.581).The prevalence of middle and high risk plaques were 10.69%(14/131)and 6.11%(8/131)in carotid arteries without stenosis,20.83%(5/24)and 20.83%(5/24)in carotid arteries with low-grade stenosis.The maximum wall thickness of carotid artery correlated positively with the degree of stenosis(r=0.430,P<0.001).Conclusion Carotid arteries with low-grade stenosis and without stenosis are still at the risk to develop vulnerable plaque.更多还原