| 摘要: |
| ［摘要］ 目的 利用3.0T高分辨率血管壁磁共振成像（HR-VW-MRI）技术分析大脑中动脉供血区域小梗死灶与大梗死灶的斑块特征。方法 回顾性分析2021年12月至2024年12月北京老年医院收治的63例大脑中动脉供血区域急性缺血性脑卒中患者的临床资料。根据弥散加权成像、表观扩散系数的表现将患者分为小皮质下梗死（SSI）组（42例）和大皮质下梗死（LSI）组（21例）。所有患者均接受HR-VW-MRI检查。观察两组斑块累及象限数目、斑块血管壁位置分布、斑块出血、斑块负荷（PB）、斑块部位的血管重塑模式和斑块部位的血管狭窄程度。结果 SSI组34例检出斑块，共34个；LSI组21例均检出斑块，共21个。两组斑块累及象限数目比较差异有统计学意义（P<0.05），SSI组斑块累及1个象限的比例更高。LSI组斑块出血比例高于SSI组，差异有统计学意义（P<0.05）。两组PB比较差异无统计学意义（P>0.05）。两组斑块血管壁位置分布比较差异无统计学意义（P>0.05），均以腹侧壁和上侧壁最为常见，其次为背侧壁，下侧壁最为少见。两组斑块部位的血管重塑模式比较差异无统计学意义（P>0.05），超过一半的斑块表现为正向重塑。两组斑块部位的血管狭窄程度比较差异有统计学意义（P<0.05），SSI组斑块部位的血管轻度狭窄占比较高，LSI组斑块部位的血管中重度狭窄占比较高。结论 SSI与LSI的斑块特征存在显著差异。与LSI相比，SSI斑块累及范围更局限，斑块部位的血管狭窄程度更轻，斑块出血比例更低。 |
| 关键词: 小皮质下梗死 大皮质下梗死 高分辨率血管壁磁共振成像 颅内动脉粥样硬化 |
| DOI：10.3969/j.issn.1674-3806.2025.12.12 |
| 分类号:R 743.3 |
| 基金项目: |
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| Analysis of plaque characteristics between small and large infarction lesions in the middle cerebral artery territory using 3.0T high-resolution vessel wall magnetic resonance imaging technology |
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ZHANG Fengling1, ZHANG Ping1, ZHANG Yanli2, FU Yan2, YANG Dandan1, LIU Jiabao3
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1.Department of Radiology, Beijing Geriatric Hospital, Beijing 100095, China; 2.Department of Neurology, Beijing Geriatric Hospital, Beijing 100095, China; 3.Department of Radiology, Beijing Friendship Hospital, Beijing 100050, China
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| Abstract: |
| ［Abstract］ Objective To analyze the plaque characteristics between small and large infarction lesions in the middle cerebral artery territory using 3.0T high-resolution vessel wall magnetic resonance imaging(HR-VW-MRI) technology. Methods The clinical data of 63 patients with acute ischemic stroke in the middle cerebral artery territory who were admitted to Beijing Geriatric Hospital from December 2021 to December 2024 were retrospectively analyzed. According to the manifestations of diffusion-weighted imaging and apparent diffusion coefficient, the patients were divided into small subcortical infarction(SSI) group(42 patients) and large subcortical infarction(LSI) group(21 patients). All the patients underwent HR-VW-MRI examination. The number of quadrants with plaque formation, distribution of plaque locations on blood vessel walls, intraplaque hemorrhage, plaque burden(PB), vascular remodeling patterns at the plaque site, and the degree of vascular stenosis at the plaque site were observed in both groups. Results Among the 42 patients in the SSI group, 34 patients were detected with plaques, totalling 34 plaques. All 21 patients in the LSI group were detected with plaques, totalling 21 plaques. There was statistically significant difference in the number of quadrants with plaque formatin between the two groups(P<0.05), with a higher proportion of the plaques involving only one quadrant in the SSI group. The proportion of intraplaque hemorrhage in the LSI group was higher than that in the SSI group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in PB between the two groups(P>0.05). There was no statistically significant difference in the distribution of plaque locations on blood vessel walls between the two groups(P>0.05), and the plaques in both groups were most commonly found on the ventral and superior abdominal walls, followed by those found on the dorsal abdominal walls, and the plaques on the inferior abdominal walls were the least common. There were no statistically significant differences in vascular remodeling patterns at the plaque site between the two groups(P>0.05), and more than half of the plaques exhibited positive remodeling. There was statistically significant difference in the degree of vascular stenosis at the plaque site between the two groups(P<0.05), with a higher proportion of mild vascular stenosis at the plaque site in the SSI group and a higher proportion of moderate to severe vascular stenosis at the plaque site in the LSI group. Conclusion There are significant differences in plaque characteristics between SSI and LSI. Compared with those in the LSI area, the plaques in the SSI area are in a more limited involvement range, and have a lesser degree of vascular stenosis at the plaque site, and a lower proportion of intraplaque hemorrhage. |
| Key words: Small subcortical infarction(SSI) Large subcortical infarction(LSI) High-resolution vessel wall magnetic resonance imaging(HR-VW-MRI) Intracranial atherosclerosis |
