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| 大脑中动脉粥样硬化性中重度狭窄斑块内出血及临床相关性 |
| Intraplaque Hemorrhage in Middle Cerebral Artery Atherosclerotic Stenosis and Clinical Relevance |
| 投稿时间：2025-06-08 修订日期：2025-06-08 |
| DOI： |
| 中文关键词: 大脑中动脉 斑块 高分辨磁共振管壁成像 |
| 英文关键词: Middle cerebral artery, Plaque, High resolution magnetic resonance vessel wall imaging |
| 基金项目: |
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| 摘要点击次数: 3 |
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| 中文摘要: |
| 目的 使用高分辨磁共振血管壁成像（high resolution magnetic resonance vessel wall imaging，HRMR-VWI）评价大脑中动脉（middle cerebral artery, MCA）粥样硬化性狭窄斑块内出血的比例及临床相关性。
方法 收集2019年7月到2023年8月我院MCA-M1或M2段中重度狭窄（50%～99%）患者行T1平扫脂肪抑制序列HRMR-VWI图像，斑块内出血定义为T1高信号，信号强度＞150%周围肌肉组织信号。对比症状性与无症状性狭窄患者以及栓塞性梗死与非栓塞性梗死的差异。
结果 最终59例患者纳入分析，30例（50.8%）为症状性狭窄，14例（23.7%）MCA狭窄病变中可见斑块内出血。症状性狭窄患者中斑块内出血11例（11/30例，36.7%），发生率高于无症状性狭窄患者（3/29例，10.3%），差异具有统计学意义（p = 0.018）。而在30例症状性狭窄患者中，11例（36.7%）患者可见动脉-动脉栓塞，其中7/11例（63.6%）可见斑块内出血，发生率高于非动脉-动脉栓塞患者（4/19例，21.1%），差异具有统计学差异（p = 0.047）。两组间的其余因素未见明显统计学差异（p 均＞0.05）。
结论 症状性MCA中重度狭窄患者斑块内出血的比例高于无症状性狭窄患者，且在症状性狭窄患者中，栓塞性梗死的患者发现斑块内出血的比例更高，对于评估MCA狭窄患者的梗死机制及卒中风险具有重要意义。 |
| 英文摘要: |
| Abstract Objective: Study for assessing intraplaque hemorrhage (IPH) in middle cerebral artery (MCA) atherosclerotic stenosis and clinical relevance is still limited. Our aim was to assess IPH in MCA atherosclerotic stenosis with high resolution magnetic resonance vessel wall imaging (HRMR-VWI). Methods: One hundred and three patients with MCA middle or severe atherosclerotic stenosis were reviewed from Jul. 2019 to Aug. 2023. Pre-contrast T1-weighted HRMR-VWI with fat suppression was performed on MCA by using a 3.0T MR scanner. On HRMR-VWI, the IPH was defined as high signal on T1-weighted fat-suppressed images with an intensity ＞150% of the signal of adjacent muscles. The plaque features and atherosclerotic risk factors between the symptomatic and asymptomatic patients, and A-to-A embolic infarction and non-A-to-A embolic infarction were compared. Results :Fifty-nine patients were finally included for analysis. Acute ischemic stroke was found in 30 of 59patients (50.8%). IPH was found in 14 of 59 cases (23.7%). IPH was found more frequently in symptomatic patients than in asymptomatic patients (36.7% vs 10.3%, p = 0.018). Furthermore, for the symptomatic patients, IPH was detected more frequently in the patients with A-to-A embolic infarction than the patients with non-A-to-A embolic infarction (63.6% vs 21.1%, p = 0.047). However, there was no statistical difference in sex, age and other atherosclerotic risk factors between the two groups (p＞0.05).Conclusions: HRMR-VWI can help assess the plaque signal characteristics for MCA atherosclerotic stenosis. Compared with asymptomatic stenosis, IPH was found more frequently in symptomatic patients. Furthermore, for the symptomatic patients, IPH was detected more frequently in the patients with A-to-A embolic infarction than the patients with non-A-to-A embolic infarction. Those findings may help to better understand the mechanisms of ischemic stroke and stroke risk. |
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