MRI、MSCT评估后循环缺血患者颅内IVBA斑块特征、形态改变与病情程度的相关性

doi:10.3969/j.issn.1671-7171.2025.01.022

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摘要【目的】探讨磁共振(MRI)、多层螺旋CT(MSCT)检查评估后循环缺血患者颅内椎基底动脉(IVBA)斑块特征、形态变化与患者病情程度的关系。【方法】回顾性分析2019年2月至2022年12月本院收治的90例后循环缺血患者的临床资料,根据MRI检查结果,将有梗死灶者纳入梗死组,无梗死灶但有相应症状的纳入短暂性脑缺血发作(TIA)组。分别于1周之内接受MRI、MSCT检查,比较两组患者的颅内IVBA斑块分布位置、特征、IVBA几何形态。【结果】MSCT检查结果显示,90例IVBA患者共102个斑块,其中椎动脉起始段检出斑块32个(31.37%)、基底动脉段检出斑块26个(25.49%),其次为椎动脉颅内段检出斑块23个(22.55%)。梗死组的软斑块检出率高于TIA组,硬斑块检出率低于TIA组,差异均有统计学意义(P<0.05)。梗死组基底动脉真实长度、基底动脉迂曲率、斑块面积、斑块负荷测定值大于TIA组,差异有统计学意义(P<0.05);梗死组的病灶血管腔面积小于TIA组,差异有统计学意义(P<0.05)。梗死组患者单侧椎动脉优势占比高于TIA组,两侧椎动脉等粗占比低于TIA组,差异有统计学意义(P<0.05)。【结论】后循环缺血患者颅内IVBA斑块特征、形态异常与患者发生脑梗死密切相关,MRI及MSCT检查能发现并评估患者IVBA病变。

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	樊小玲
	高岚

关键词 ：脑梗死, 磁共振成像, 体层摄影术,螺旋计算机, 斑块,动脉粥样硬化, 病人病情

Abstract：【Objective】To explore the relationship of disease severity with the characteristics and morphological changes of intracranial vertebrobasilar artery (IVBA) plaques in patients with posterior circulation ischemia evaluated by magnetic resonance imaging (MRI) and multi-slice spiral CT (MSCT). 【Methods】A retrospective analysis was conducted on the clinical data of 90 patients with posterior circulation ischemia admitted to our hospital from February 2019 to December 2022. Based on the MRI examination results, patients with infarction lesions were included in the infarction group, while those without infarction lesions but with corresponding symptoms were included in the TIA group. MRI and MSCT examinations were performed within one week to compare the distribution, characteristics, and geometric morphology of intracranial IVBA plaques between the two groups of patients. 【Results】The MSCT examination results showed a total of 102 plaques in 90 IVBA patients, including 32 plaques (31.37%) detected in the initial segment of vertebral artery, 26 plaques (25.49%) detected in the basilar artery segment of vertebral artery, and 23 plaques (22.55%) detected in the intracranial segment of the vertebral artery. The detection rate of soft plaques in the cerebral infarction group was higher than that in the TIA group, while the detection rate of hard plaques was lower than that in the TIA group, and the differences were statistically significant (P<0.05). The true length, tortuosity rate, plaque area, and plaque burden of the basal artery in the cerebral infarction group were greater than those in the TIA group, and the differences were statistically significant (P<0.05). The lesion vascular lumen area in the cerebral infarction group was lower than that in the TIA group, and the difference was statistically significant (P<0.05). The proportion of unilateral vertebral artery dominance in the cerebral infarction group was higher than that in the TIA group, and the proportion of equally thick vertebral arteries on both sides was lower than that in the TIA group, with statistical significance (P<0.05). 【Conclusion】The characteristics and morphological abnormalities of intracranial IVBA plaques in patients with posterior circulation ischemia are closely related to the occurrence of cerebral infarction. MRI and MSCT examinations can detect and evaluate IVBA lesions in patients.

Key words： Brain Infarction Magnetic Resonance Imaging Tomography,Spiral Computed Plaque,Atherosclerotic Patient Acuity

收稿日期: 2023-07-13

中图分类号:

R743.33

通讯作者: *E-mail:GL18161777931@126.com

引用本文:

樊小玲, 高岚. MRI、MSCT评估后循环缺血患者颅内IVBA斑块特征、形态改变与病情程度的相关性[J]. 医学临床研究, 2025, 42(1): 78-81.
FAN Xiaoling, GAO Lan. Relationship of Disease Severity with the Characteristics and Morphological Changes of IVBA Plaques in Patients with Posterior Circulation Ischemia Evaluated by MRI and MSCT. JOURNAL OF CLINICAL RESEARCH, 2025, 42(1): 78-81.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.01.022 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I1/78

[1] PIANO M, MILONIA L, CERVO A, et al. Endovascular treatment of symptomatic intracranial vertebrobasilar stenosis: a 10-year single centre experience using balloon-expandable coronary artery stents[J].J Stroke Cerebrovasc Dis,2021,30(1):e105431.
[2] NOVAKOVIC-WHITE R, CORONA J M, WHITE J A. Posterior circulation ischemia in the endovascular era[J].Neurology,2021,97(20):S158-S169.
[3] 葛树勇,王庆祝,王相报,等. CTA评估后循环脑缺血椎基底动脉粥样斑块性质的研究[J].神经损伤与功能重建,2022,17(3):159-161.
[4] SZALONTAI L, JOKKEL Z, HORVATH T, et al. Are the morphological indices of the vertebrobasilar system heritable? A twin study based on 3D reconstructed models[J].Medicina (Kaunas),2021,57(2):127-128.
[5] 中国后循环缺血专家共识组.中国后循环缺血的专家共识[J].中华内科杂志, 2006, 45(9):786-787.
[6] WANG Y S, HUANG J R, QIAN G Z,et al.Study on the correlation between different levels of patients with vertebrobasilar dolichoectasia and posterior circulation blood perfusion[J].J Stroke Cerebrovasc Dis,2022, 31(5):e106378.
[7] 严雪娇,高洁,张东升,等. 症状性基底动脉粥样硬化病人斑块特征与血管几何形态的HR-MRI研究[J].国际医学放射学杂志,2021,44(1):6-12.
[8] 周围,陈峥杰,陆敏茹,等. 脑后循环缺血患者功能性后交通动脉的相位对比MR血管成像研究[J].中华放射学杂志,2020,54(4):332-337.
[9] 刘昱琳,刘红军,李品雄,等. 高分辨率MRI分析基底动脉几何形态与其动脉粥样硬化斑块的相关性[J].中国医学影像技术,2022,38(8):1145-1150.
[10] 周莹雪,崔英哲,南东,等. 后循环脑缺血的基底动脉高分辨磁共振成像研究[J].磁共振成像,2021,12(2):15-18.
[11] 卢哲,刘华坤,初建峰. 后循环缺血性卒中的病因学和治疗[J].国际脑血管病杂志,2020,28(3):202-205.
[12] 孙宜永,闫鹏,李珊,等. 椎动脉发育不良与急性单发后循环梗死患者梗死部位和椎-基底动脉形态及斑块特征关系的研究[J].中国脑血管病杂志,2023,20(4):230-238.
[13] 沈红健,沈芳,尹伟,等. 基于CT灌注成像的pc-ASPECTS对椎基底动脉闭塞急性缺血性脑卒中预后的预测价值[J].第二军医大学学报,2022,43(1):42-48.
[14] 边祥兵,林家骥,张森皓,等.颅内椎-基底动脉夹层形态学与后循环缺血程度的相关性研究[J].中国卒中杂志, 2021, 16(5):440-445.
[15] 赵娜,李东旭,许晓冬,等. 磁共振血管成像定量研究脑后循环缺血患者的功能性后交通动脉的血流动力学特征[J].临床和实验医学杂志,2021,20(7):770-772.