| 罗丹,饶忠亮,肖新兰.高分辨MR血管壁成像鉴别穿支型与其他亚型基底动脉缺血性脑卒中[J].中国医学影像技术,2025,41(1):50~54 |
| 高分辨MR血管壁成像鉴别穿支型与其他亚型基底动脉缺血性脑卒中 |
| High-resolution MR vascular wall imaging for differentiating perforating branch subtype and other subtype basilar artery ischemic stroke |
| 投稿时间：2024-07-08 修订日期：2024-09-03 |
| DOI：10.13929/j.issn.1003-3289.2025.01.011 |
| 中文关键词: 卒中 基底动脉 磁共振成像 |
| 英文关键词:stroke basilar artery magnetic resonance imaging |
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| 中文摘要: |
| 目的 观察高分辨血管壁成像(HR-VWI)鉴别穿支型与其他亚型基底动脉(BA)缺血性脑卒中的价值。方法 回顾性分析147例后循环缺血性卒中,根据MRI所见及中国缺血性卒中亚型(CISS)分型将其分为穿支组(穿支型BA粥样硬化,n=57)与多机制组(动脉到动脉栓塞和/或低灌注,n=90);比较组间临床资料、HR-VWI及MR血管成像参数;将差异有统计学意义者纳入logistic回归分析,并据以构建模型;绘制受试者工作特征曲线,计算曲线下面积(AUC),评估模型鉴别穿支型与其他亚型BA缺血性脑卒中的效能。结果 穿支组罹患糖尿病(DM)及背侧斑块占比高于、腹侧斑块占比低于多机制组(P均＜0.05);组间其余临床资料,责任斑块层面最厚管壁厚度、管腔偏心指数、管腔面积、管壁面积,以及血管狭窄率、斑块负荷、血管重构指数及BA走行差异均无统计学意义(P均＞0.05)。DM及背侧斑块均为穿支型BA粥样硬化的独立危险因素,腹侧斑块为其独立保护因素(P均＜0.05);以之构建的模型鉴别穿支型与其他亚型BA缺血性脑卒中的敏感度、特异度及AUC分别为82.46%、70.00%及0.839。结论 HR-VWI可用于鉴别穿支型与其他亚型BA缺血性脑卒中。 |
| 英文摘要: |
| Objective To observe the value of high-resolution vascular wall imaging (HR-VWI) for differentiating perforating branch subtype and other subtype basilar artery (BA) ischemic stroke. Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group (perforating branch BA atherosclerosis, n=57) and multi-mechanism group (artery-to-artery embolism and/or hypoperfusion, n=90) according to MRI findings and Chinese ischemic stroke subclassification (CISS). Clinical data, HR-VWI and MR angiography parameters were compared between groups, and those being significantly different were included in logistic regression analysis to construct a model. Receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke. Results The proportion of diabetes mellitus (DM) and dorsal plaque were both higher, while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group (all P＜0.05). No significant difference of the other clinical data, nor of the maximum wall thickness, lumen eccentricity index, lumen area, wall area, vascular stenosis rate, plaque load, vascular remodeling index and BA course of culprit plaques section was found between groups (all P＞0.05). DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis, whereas ventral plaque was the independent protective factor (all P＜0.05). The sensitivity, specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46%, 70.00% and 0.839, respectively. Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke. |
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