發(fā)布時間：2018-03-03 02:34

  本文選題：動脈閉塞性疾病　切入點：高分辨率磁共振成像　出處：《中國腦血管病雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的探討高分辨率MRI(high-resolution MRI,HR-MRI)在頭頸部動脈閉塞患者病因診斷中的價值。方法前瞻性連續(xù)納入2015年12月至2017年2月首都醫(yī)科大學(xué)宣武醫(yī)院急性頭頸動脈閉塞患者25例,采用32通道頭頸聯(lián)合專用線圈行頭頸一體化HR-MRI成像,分析閉塞血管節(jié)段局部管壁特征和閉塞中遠段腔內(nèi)血栓信號特征。由2名神經(jīng)內(nèi)科醫(yī)師結(jié)合納入患者的臨床病史、實驗室檢查、影像學(xué)檢查對閉塞病因進行評價并作為參考標(biāo)準,比較常規(guī)管腔成像技術(shù)與常規(guī)管腔成像聯(lián)合HR-MRI在病因分類中的準確率。結(jié)果 (1)25例急性頭頸動脈閉塞患者均完成HR-MRI檢查,共診斷閉塞血管31段,其中常規(guī)管腔成像診斷了21段,常規(guī)管腔成像+HR-MRI診斷了30段;動脈硬化性閉塞24段(19例),動脈夾層性閉塞4段(4例),動脈炎性閉塞3段(2例)。(2)動脈硬化性閉塞患者中,閉塞節(jié)段近端管壁均可見偏心性增厚;動脈夾層性閉塞均見典型的雙腔征或新月形高信號壁內(nèi)血腫;血管炎性閉塞血管節(jié)段中可見長節(jié)段環(huán)形增厚及強化。(3)常規(guī)管腔成像技術(shù)與常規(guī)管腔成像聯(lián)合HR-MRI對病因分類診斷的準確率分別為67.7%(21/31)和96.8%(30/31),差異有統(tǒng)計學(xué)意義(P0.01)。結(jié)論相較于常規(guī)管腔成像技術(shù),頭頸聯(lián)合HR-MRI可顯示閉塞起始段動脈管壁特征,對判讀動脈粥樣硬化、動脈夾層和動脈炎性病變等病因具有一定優(yōu)勢。
[Abstract]:Objective to evaluate the value of HR-MRI in the etiological diagnosis of head and neck artery occlusion (CAO). Methods 25 patients with acute head and carotid artery occlusion (CAO) in Xuanwu Hospital of Capital Medical University from December 2015 to February 2017 were included prospectively. 32 channel head and neck combined with special coil were used for head and neck integrated HR-MRI imaging to analyze the characteristics of local wall of occluded vascular segment and the characteristics of thrombus signal in middle and distal segment of occlusion. Two neurologists were combined with two neurologists in the clinical history of the patients. Laboratory examination, imaging examination to evaluate the etiology of occlusion and as a reference standard, The accuracy of conventional lumen imaging and conventional luminal imaging combined with HR-MRI in etiological classification was compared. Results all 25 patients with acute head and neck artery occlusion completed HR-MRI examination, and 31 segments of occluded vessels were diagnosed, among which 21 segments were diagnosed by conventional lumen imaging. In 30 patients with arteriosclerotic occlusion, 19 with arteriosclerotic occlusion, 4 with dissecting occlusion, 2 with inflammatory occlusion and 2 with arteriosclerotic occlusion, the proximal wall of the occluded segment was eccentrically thickened. Typical double-lumen sign or crescent hyperintense intramural hematoma was found in all patients with arterial dissecting occlusion. The accuracy of conventional lumen imaging and conventional lumen imaging combined with HR-MRI in the diagnosis of etiological classification was 67.7% 21 / 31) and 96.880% 30 / 31% respectively. The difference was statistically significant (P 0.01). Compared with conventional lumen imaging, The combination of head and neck combined with HR-MRI can show the characteristics of the artery wall in the initial segment of occlusion, which has a certain advantage in judging the causes of atherosclerosis, dissection and inflammatory diseases.
【作者單位】： 首都醫(yī)科大學(xué)宣武醫(yī)院放射科;首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)內(nèi)科;首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)外科;
【基金】：國家自然科學(xué)基金(81322022)
【分類號】：R445.2;R743.3

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