本文關(guān)鍵詞：頸動(dòng)脈粥樣硬化斑塊與急性腦梗死體積的相關(guān)性研究　出處：《天津醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 急性腦梗死 頸動(dòng)脈粥樣硬化 斑塊 磁共振成像 高分辨率

【摘要】：目的:應(yīng)用3.0T多序列高分辨率MRI對(duì)頸動(dòng)脈斑塊進(jìn)行分型、定量測(cè)量斑塊負(fù)荷并分析其組成成分,探討頸動(dòng)脈斑塊分型、負(fù)荷及組成成分與急性腦梗死的相關(guān)性。方法:選取65例頸內(nèi)動(dòng)脈供血區(qū)急性腦梗死患者,使用Philips Intera Achieva 3.0T MRI掃描儀,于發(fā)病7天內(nèi)行頭顱和雙側(cè)頸動(dòng)脈MRI檢查(頭顱掃描序列包括T1WI、T2WI、FLAIR及DWI;頸動(dòng)脈掃描序列包括T1WI、T2WI、MP-RAGE及3D-TOF)。在DWI序列上測(cè)量急性腦梗死體積;根據(jù)蔡劍鳴等制定的頸動(dòng)脈斑塊的MRI分型標(biāo)準(zhǔn),采用CASCADE軟件對(duì)斑塊進(jìn)行分型,并分析其組成成分;測(cè)量平均頸動(dòng)脈管腔面積(LA)、平均血管總面積(TVA),計(jì)算出平均管壁面積(WA)、平均管壁標(biāo)準(zhǔn)化指數(shù)(NWI);測(cè)量頸動(dòng)脈斑塊內(nèi)脂質(zhì)核心體積。采用SPSS 20.0統(tǒng)計(jì)學(xué)軟件,計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用χ2檢驗(yàn),缺血側(cè)斑塊平均標(biāo)準(zhǔn)化指數(shù)及斑塊內(nèi)脂質(zhì)核心體積與同側(cè)急性腦梗死體積的關(guān)系采用Spearman秩相關(guān)分析,P0.05被認(rèn)為有統(tǒng)計(jì)學(xué)意義。結(jié)果:(1)65例病例中,60例患者圖像質(zhì)量符合要求;(2)缺血側(cè)頸動(dòng)脈Ⅳ-Ⅴ型及Ⅵ型斑塊的發(fā)生率、斑塊內(nèi)脂質(zhì)核心的發(fā)生率、平均管壁面積(WA)以及平均管壁標(biāo)準(zhǔn)化指數(shù)(NWI)均高于非缺血側(cè),差異具有統(tǒng)計(jì)學(xué)意義(P0.05)(3)缺血側(cè)頸動(dòng)脈平均管壁標(biāo)準(zhǔn)化指數(shù)(NWI)及斑塊內(nèi)脂質(zhì)核心體積與同側(cè)急性腦梗死體積具有較強(qiáng)的正相關(guān)性(P0.05)。結(jié)論:頸動(dòng)脈粥樣硬化斑塊與急性腦梗死的發(fā)生密切相關(guān),3.0T MR能夠清晰顯示頸動(dòng)脈斑塊的組成成分,對(duì)頸動(dòng)脈斑塊進(jìn)行分型、定量測(cè)量頸動(dòng)脈管壁負(fù)荷以及斑塊內(nèi)部成分的體積,從而對(duì)預(yù)測(cè)腦缺血事件的發(fā)生、監(jiān)控病情的發(fā)展提供幫助。
[Abstract]:Objective: the application of multiple 3.0T sequences of high resolution MRI of carotid artery plaque type, quantitative measurement and analysis of the components of plaque burden, to investigate the correlation of carotid artery plaque type, load and composition with acute cerebral infarction. Methods: 65 cases of internal carotid artery blood supply area of acute cerebral infarction patients, the use of Philips Intera Achieva 3.0T MRI the scanner, in 7 days of onset underwent head and bilateral carotid artery MRI examination (MRI scanning sequences included T1WI, T2WI, FLAIR and DWI; carotid artery scanning sequences included T1WI, T2WI, MP-RAGE and 3D-TOF). The measurement of the volume of acute cerebral infarction in the DWI sequence; according to the carotid plaque to Cai Jianming's MRI classification standard the plaques were classified according to CASCADE software, and analyzed its composition; measuring the mean carotid artery lumen area (LA), the average total vessel area (TVA), calculated the average wall area (WA), average wall standard Index (NWI); lipid core volume measurement of carotid artery plaque. Using SPSS 20 statistical software, measurement data using t test, count data using 2 test, ischemic side plaque lipid core volume average standard index and plaque and ipsilateral volume of acute cerebral infarction with Spearman rank correlation analysis, P0.05 is considered there was statistical significance. Results: (1) in 65 cases, 60 cases of patients with image quality to meet the requirements; (2) the incidence of ischemic carotid artery - IV V and VI type of plaque, the incidence rate of plaque lipid core, the average wall area (WA) and the average normalized wall index (NWI) were higher than those in non ischemic side, the difference was statistically significant (P0.05) (3) ischemic carotid artery average normalized wall index (NWI) and lipid core plaques in the same side with the volume of the volume of acute cerebral infarction has a strong positive correlation (P0.05). Conclusion: carotid artery congee Atherosclerosis plaque and acute cerebral infarction is closely related to the occurrence of 3.0T and MR can clearly show the composition of carotid plaque, carotid artery plaque type, measurement of carotid artery wall plaque volume quantitative load and internal components, in order to forecast the occurrence of cerebral ischemic events, help the development of monitoring condition.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R743.33
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本文編號(hào)：1415364