本文選題：動(dòng)脈粥樣硬化　切入點(diǎn)：主動(dòng)脈　出處：《中國(guó)醫(yī)學(xué)影像學(xué)雜志》2017年08期

【摘要】：目的胸主動(dòng)脈粥樣硬化斑塊是老年人缺血性卒中栓子的重要來(lái)源。本研究擬應(yīng)用三維磁共振管壁成像技術(shù)評(píng)價(jià)老年人胸主動(dòng)脈粥樣硬化易損斑塊的特征,從而積極預(yù)防心腦血管并發(fā)癥的發(fā)生。資料與方法前瞻性選取60歲以上且無(wú)任何嚴(yán)重心腦血管癥狀的老年人53例,分為60~74歲組(A組)和75~89歲組(B組)。全部受試者均接受磁共振胸主動(dòng)脈管壁多對(duì)比度序列掃描。將胸主動(dòng)脈分為升主動(dòng)脈段、主動(dòng)脈弓段和降主動(dòng)脈段3個(gè)節(jié)段,評(píng)價(jià)其粥樣硬化斑塊的特征。定量測(cè)量老年人群胸主動(dòng)脈粥樣硬化斑塊的負(fù)荷特征,并定性分析其成分特征。結(jié)果老年人胸主動(dòng)脈粥樣硬化斑塊內(nèi)出血的發(fā)生率為26.4%(14/53),脂質(zhì)核的發(fā)生率為94.3%(50/53)。同時(shí),B組升主動(dòng)脈段、主動(dòng)脈弓段和降主動(dòng)脈段3個(gè)節(jié)段的最大管壁厚度均顯著大于A組[(3.1±0.6)mm比(3.0±0.4)mm,P0.05;(3.2±0.7)mm比(3.1±0.7)mm,P0.05;(3.0±0.8)mm比(2.9±0.7)mm,P0.001];B組3個(gè)節(jié)段的標(biāo)準(zhǔn)化管壁指數(shù)均顯著大于A組[(26.9±3.5)%比(26.7±2.9)%,P0.001;(31.9±5.1)%比(31.0±5.1)%,P0.001;(34.6±5.0)%比(34.1±4.6)%,P0.001]。結(jié)論老年人胸主動(dòng)脈粥樣硬化斑塊內(nèi)出血的發(fā)生率較高,且斑塊負(fù)荷隨年齡增長(zhǎng)而逐漸增大。因此,應(yīng)用磁共振管壁成像早期識(shí)別老年人胸主動(dòng)脈的易損斑塊,將有助于腦卒中的預(yù)防及治療。
[Abstract]:Objective Atherosclerotic plaque of thoracic aorta is an important source of embolus in elderly patients with ischemic stroke. Data and methods 53 elderly patients over 60 years of age without any serious cardiovascular and cerebrovascular symptoms were selected prospectively to prevent the occurrence of cardiovascular and cerebrovascular complications. They were divided into group A (60 ~ 74 years old) and group B (75 ~ 89 years old). All subjects were scanned with magnetic resonance multiple contrast sequence. The thoracic aorta was divided into three segments: ascending aorta segment, aortic arch segment and descending aortic segment. To evaluate the characteristics of atherosclerotic plaques and to measure quantitatively the load characteristics of atherosclerotic plaques in the thoracic aorta of the elderly. Results the incidence of intracerebral hemorrhage of thoracic aortic atherosclerotic plaque in the elderly was 26.4%, and the incidence of lipid nucleus was 94.33 / 50 / 53. At the same time, the ascending aortic segment in group B. The maximum wall thickness of three segments of aortic arch and descending aorta in group B was significantly larger than that in group A [3.1 鹵0.6)mm vs 3.0 鹵0.4mm P0.05U / 0.7)mm vs 3.1 鹵0.7mm P0.05ng / 0.8)mm vs 2.9 鹵0.7mm / P0.001]. Conclusion the standardized wall index of three segments of group B is significantly higher than that of group A [26.9 鹵3.5% vs 26.7 鹵2.9 鹵2.9mm / P = 31.9 鹵5.1% vs 31.0 鹵5.1g / 31.0 鹵5.1g / 34.6 鹵5.0g% vs 34.1 鹵4.6p0.001] .Conclusion there is no significant difference between group A and group A [26.9 鹵3.5U% vs 26.7 鹵2.9mm / P > 31.9 鹵5.1% vs 31.0 鹵5.1U% vs 34.6 鹵5.0g% vs 34.1 鹵4.6p0.001]. The incidence of intracerebral hemorrhage in atherosclerotic plaque was higher. The plaque load increases with age. Therefore, the early identification of vulnerable plaques in the thoracic aorta of the elderly by magnetic resonance wall imaging will be helpful to the prevention and treatment of stroke.
【作者單位】： 揚(yáng)州大學(xué)第二臨床醫(yī)學(xué)院放射科;清華大學(xué)生物醫(yī)學(xué)工程系生物醫(yī)學(xué)影像研究中心;東南大學(xué)附屬中大醫(yī)院放射科;美國(guó)華盛頓大學(xué)放射科;
【基金】：國(guó)家自然科學(xué)基金(81271536)
【分類號(hào)】：R445.2;R543.1

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