摘要
目的分析颅内动脉斑块高分辨率MRI对急性脑梗死患者斑块负荷和斑块性质的诊断效能。方法回顾性分析平顶山市第二人民医院2022年02月~2025年01月收治的118例急性脑梗死患者的临床资料,患者均接受颅内动脉斑块高分辨率MRI检查,以数字减影血管造影为诊断斑块性质的“金标准”,根据斑块性质的不同分为易损组(易损斑块,n=68)和稳定组(稳定斑块,n=50),分析颅内动脉斑块高分辨率MRI对急性脑梗死患者斑块性质的诊断效能,再对比两组颅内动脉斑块负荷相关指标[管腔面积(LA)、血管总面积(TVA)、管壁面积(WA)、管壁比较标准化指数(NWI)、管腔狭窄率],分析量化颅内动脉斑块高分辨率MRI斑块负荷相关指标对不同性质斑块的诊断价值。结果高分辨率MRI的敏感度为92.64%,特异度为94.00%,阳性预测值为95.45%,阴性预测值为90.38%,准确度为93.22%,Kappa值为0.861。两组LA、TVA、WA比较无统计学意义(P>0.05),易损组NWI、管腔狭窄率高于对照组(P<0.05)。NWI、管腔狭窄率曲线的AUC略高于参考线(AUC>0.5),NWI、管腔狭窄率敏感度分别为66.18%、63.24%,特异度分别为70.00、64.00%,其cut-off值分别为71.53%、51.20%。结论颅内动脉斑块高分辨率MRI能准确诊断急性脑梗死患者斑块性质,定量测量颅内动脉斑块负荷以及血管腔狭窄情况,可为临床治疗方案的选择提供有利参考。
Objective To analyze the diagnostic efficiency of intracranial artery plaque high-resolution MRI on plaque load and plaque properties in patients with acute cerebral infarction.Methods The clinical data of 118 patients with acute cerebral infarction admitted to Pingdingshan Second People’s Hospital from February 2022 to January 2025 were retrospectively analyzed.All patients received intracranial artery plaque high-resolution MRI examination.Digital subtraction angiography was used as the gold standard for the diagnosis of plaque properties.According to the plaque properties,they were divided into vulnerable group(vulnerable plaque,n=68)and stable group(stable plaque,n=50).The diagnostic efficiency of intracranial artery plaque high-resolution MRI on plaque properties in patients with acute cerebral infarction was analyzed.The related indexes of intracranial artery plaque load[lumen area(LA),total vascular area(TVA),wall area(WA),normalized wall index(NWI),lumen stenosis rate]were compared between the two groups,and the diagnostic value of intracranial artery plaque high-resolution MRI plaque load-related indexes on different types of plaques was analyzed and quantified.Results The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Kappa value of high-resolution MRI were 92.64%,94.00%,95.45%,90.38%,93.22%and 0.861.There were no statistical differences in LA,TVA and WA between the two groups(P>0.05),but the NWI and lumen stenosis rate in vulnerable group were higher than those in control group(P<0.05).The AUCs of NWI and lumen stenosis rate were slightly higher than the reference line(AUC>0.5),and the sensitivities of NWI and lumen stenosis rate were 66.18%and 63.24%,and the specificities were 63.24%and 64.00%,and the cut-off values were 71.53%and 51.20%respectively.Conclusions Intracranial artery plaque high-resolution MRI can accurately diagnose the plaque properties in patients with acute cerebral infarction,and quantitatively measure intracranial artery plaque load and vascular stenosis,which can provide a favorable reference for the selection of clinical treatment regimen.
作者
高静静
鲍燕
潘梦音
陈少武
GAO Jingjing;BAO Yan;PAN Mengyin;CHEN Shaowu(MRI room,The Second People's Hospital of Pingdingshan City,Pingdingshan,Henan 467000,China;MRI room,The First People's Hospital of Pingdingshan City,Pingdingshan,Henan 467000,China)
出处
《航空航天医学杂志》
2025年第9期1038-1041,共4页
Journal of Aerospace medicine
关键词
颅内动脉斑块
高分辨率磁共振成像
急性脑梗死
斑块负荷
斑块性质
Intracranial artery plaque
High-resolution magnetic resonance imaging
Acute cerebral infarction
Plaque load
Plaque properties
