【摘要】 目的 通过高分辨率磁共振成像(HR-MRI)评估椎动脉夹层(VAD)致后循环缺血性卒中的影像学特征。方法 选取56例高度疑似VAD患者。根据HR-MRI特征将患者分为缺血卒中组(23例)和对照组(33例),分析2组影像学特征与危险因素的相关性。结果 缺血卒中组出现壁内血肿、瘤样扩张、血管壁强化程度的比例明显高于对照组,差异有统计学意义(P<0.05),而在双腔征、内膜瓣征方面差异无统计学意义(P=0.075)。相关性分析表明,有效管腔指数与VAD患者后循环缺血性卒中的发生率呈显著负相关(r=-0.721,P<0.05),且有效管腔指数的曲线下面积(AUC)达到0.935。结论 HR-MRI诊断VAD致后循环缺血性卒中的有效特征包括壁内血肿、瘤样扩张、血管壁强化程度和有效管腔指数的降低,有助于VAD患者的管理和预测。更多还原

【Abstract】 Objective To evaluate the imaging features of posterior circulation ischemic stroke caused by vertebral artery dissection(VAD) by high-resolution magnetic resonance imaging(HR-MRI).Methods A total of 56 patients with highly suspected VAD were selected.According to HR-MRI characteristics,these patients were divided into ischemic stroke group(n=23) and control group(n=33).The correlation between imaging features and risk factors in the two groups was analyzed.Results The proportions of intramural hematoma,tumor-like dilatation,and degree of vessel wall enhancement in the ischemic stroke group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).However,there was no statistical significance in the double-chamber sign and intimal valve sign(P=0.075).Correlation analysis showed that the effective lumen index was significantly negatively correlated with the incidence of posterior circulation ischemic stroke in patients with VAD(r=-0.721,P<0.05),and the area under the curve(AUC) of the effective lumen index reached 0.935.Conclusion The effective features of HR-MRI in the diagnosis of posterior circulation ischemic stroke caused by VAD include intramural hematoma,tumor-like dilatation,degree of vessel wall enhancement,and reduction of effective lumen index,which are helpful for the management and prediction of patients with VAD.更多还原