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目的应用高分辨率磁共振(HR-MRI)管壁成像技术研究基底动脉粥样硬化性梗死两种类型——穿支闭塞型病变(BOD)和非穿支闭塞型病变(non-BOD)的血管重构与斑块特征。方法将32例症状性基底动脉狭窄患者分为BOD 18例,non-BOD 14例。应用3.0T HR-MRI对基底动脉进行管壁增强扫描,然后使用CMRtools软件对血管狭窄最严重的层面的管壁及斑块面积等参数进行测量,研究血管的重构和斑块特征。结果 HR-MRI管壁成像结果显示,non-BOD组血管狭窄程度较BOD组更明显[(68.9%±19.1)%vs(43.8%±18.8)%,P=0.017]。正性重构更常见于non-BOD(57.2%vs16.7%,P=0.036)。BOD组管壁面积指数小于non-BOD组(P<0.001)。两组血管强化均以偏心性为主,两组斑块强化比例差异无统计学意义(P=0.196),但BOD组强化程度小于non-BOD组[(39.9±23.2)%vs(65.3±21.1)%,P=0.004]。结论基底动脉BOD梗死和non-BOD型梗死在血管重构和斑块性质方面的特征各不相同。
Objective To investigate the effects of two types of basilar atherosclerotic infarction (BOD) and non-BOD on high-resolution magnetic resonance (HR-MRI) Vascular remodeling and plaque characteristics. Methods Twenty-two patients with symptomatic basilar artery stenosis were divided into BOD 18 cases and non-BOD 14 cases. The basilar artery was scanned with 3.0T HR-MRI. The CMRtools software was used to measure the wall and plaque area of the most serious vessel stenosis to study the remodeling and plaque features. Results The wall imaging of HR-MRI showed that the degree of stenosis in non-BOD group was more significant than that in BOD group (68.9% ± 19.1% vs 43.8% ± 18.8%, P = 0.017). Positive remodeling was more common in non-BOD (57.2% vs 16.7%, P = 0.036). The wall area index of BOD group was less than that of non-BOD group (P <0.001). There was no significant difference in plaque enhancement ratio between the two groups (P = 0.196), but the degree of enhancement in BOD group was less than that in non-BOD group [(39.9 ± 23.2)% vs (65.3 ± 21.1 )%, P = 0.004]. Conclusions The features of vascular remodeling and plaque in BOD infarction and non-BOD infarction in basilar artery are different.