摘要
目的探讨高分辨率磁共振成像(HR-MRI)检查对非狭窄性颅内动脉粥样硬化所致卒中再发的预测价值。方法选取153例非狭窄性颅内动脉粥样硬化所致卒中患者,收集患者入院时的临床资料和HR-MRI检查资料。随访3个月,根据随访期间是否再次发生卒中将患者分成复发组42例和稳定组111例。比较两组HR-MRI影像学特征及临床参数,采用Logistic回归分析筛选卒中再发的影响因素,采用ROC曲线分析相关影响因素对卒中再发的预测效能。结果复发组糖尿病占比高于稳定组(P<0.05);复发组颈内动脉颅内段斑块比例增加,斑块负担、偏心指数、斑块体积、斑块内出血发生率高于稳定组(P均<0.05)。Logistic回归分析显示,斑块位置、斑块负担、斑块体积是卒中再发的危险因素(P均<0.05)。ROC曲线分析显示,斑块位置、斑块负担、斑块体积预测卒中再发的AUC分别为0.637、0.660、0.860;三项指标联合的AUC为0.890,高于三项指标单独预测(P<0.05)。结论HR-MRI检查对非狭窄性颅内动脉粥样硬化所致卒中再发具有较高的预测价值。
Objective To explore the predictive value of high resolution magnetic resonance imaging(HR-MRI)in stroke recurrence caused by non-stenotic intracranial atherosclerosis.Methods The clinical and HR-MRI examination data of 153 patients with stroke caused by non-stenotic intracranial atherosclerosis were collected at admission.During a 3-month follow-up,according to whether they experienced another stroke during the follow-up period,the patients were divided into two groups:the recurrent group(n=42)and the stable group(n=111).The HR-MRI imaging features and clinical parameters were compared between two groups of patients.Then,using logistic regression analysis,we screened the influencing factors of stroke recurrence,and evaluated the predictive power of relevant influencing factors for stroke recurrence by means of ROC curve analysis.Results Patients in the recurrence group had a higher proportion of diabetes(P<0.05);in the recurrent group,more plaques were located in the intracranial segment of the internal carotid artery,and the plaque burden,eccentric index,plaque volume,and intra-plaque hemorrhage were higher(all P<0.05).Logistic regression analysis showed that plaque location,plaque burden and plaque volume were risk factors for stroke recurrence(all P<0.05).ROC curve analysis showed that the area under the curve for predicting stroke recurrence based on plaque position,plaque burden,and plaque volume was 0.637,0.660 and 0.860,respectively.The AUC of the three indicators combined was 0.890,which was higher than the prediction of three indicators alone(P<0.05).Conclusion HR-MRI has a high predictive value for stroke recurrence caused by non-stenotic intracranial atherosclerosis.
作者
朱秀芳
陈磊
段新秀
李蕾
ZHU Xiufang;CHEN Lei;DUAN Xinxiu;LI Lei(Imaging Department of Lianyungang First People's Hospital,Lianyungang 222000,China)
出处
《医学影像学杂志》
2025年第10期20-24,共5页
Journal of Medical Imaging
基金
连云港市科技重点研发计划项目(编号:SF2315)。
关键词
磁共振成像
非狭窄性颅内动脉粥样硬化
卒中再发
Magnetic resonance imaging
Non stenotic intracranial atherosclerosis
Stroke recurrenc
