目的探讨3D高分辨率磁共振成像(HRMRI)评估症状性基底动脉粥样硬化性重度狭窄重构模式的价值。方法搜集2015年1月至2017年12月经颅脑磁共振血管造影(MRA)显示症状性基底动脉重度狭窄(70～99%)的患者44例,使用VISTA技术对颅内动脉进行轴...目的探讨3D高分辨率磁共振成像(HRMRI)评估症状性基底动脉粥样硬化性重度狭窄重构模式的价值。方法搜集2015年1月至2017年12月经颅脑磁共振血管造影(MRA)显示症状性基底动脉重度狭窄(70～99%)的患者44例,使用VISTA技术对颅内动脉进行轴位扫描,获得容积数据进行后处理重建,得到基底动脉最窄层面、近端参考层面的短轴横断面图像,并分别测量其血管面积和管腔面积,计算重构指数(RI)(最窄层面血管面积/参考层面血管面积),RI≥1为阳性重构,RI<1为阴性重构。然后比较阳性重构和阴性重构组之间临床资料及血管参数的差异。结果 2例患者因图像质量差而被排除,最终42例患者纳入分析。其中22例(52.4%)为阳性重构,20例(47.6%)为阴性重构。在最窄层面,阳性重构组比阴性重构组有更大的血管面积、管壁面积、斑块面积及斑块负荷(P均<0.05)。临床基线数据无统计学差异(P均>0.05)。结论 3D HRMRI可以准确评估症状性基底动脉粥样硬化性狭窄的血管重构模式,具有重要的临床意义。展开更多
Background:Endovascular treatment(EVT)is an alternative option for symptomatic intracranial atherosclerotic disease(ICAD).However,the effect of EVT treatment on ICAD plaques is still unclear.This study describes the I...Background:Endovascular treatment(EVT)is an alternative option for symptomatic intracranial atherosclerotic disease(ICAD).However,the effect of EVT treatment on ICAD plaques is still unclear.This study describes the ICAD plaque characteristics after EVT treatment and analyzes the effect of different EVT treatments on plaque characteristics.Method:From 2017 January to 2022 January,ICAD patients who underwent endovascular treatment and had follow-up high-resolution magnetic resonance image(HRMRI)were enrolled in the study.Multiple plaque characteristics,including plaque enhancement,plaque burden,were measured based on preoperative,and follow-up HRMRI.Plaque characteristics and postoperative plaque changes were analyzed between different treatment groups.Result:Finally,50 intracranial atherosclerotic plaques in 45 patients were included.Including 28 male patients and 17 female,media age 63.0 years old.Among 50 plaques,41 received percutaneous angioplasty(including 22 plain balloons and 19 drug-coated balloons(DCB))and the other 9 underwent stenting.Stenosis rate,plaque burden and eccentricity index at the lesion site were significantly decreased after EVT compared with preoperative periods(p<0.001).And only the DCB group showed a significant reduction in plaque enhancement at follow-up(p<0.001).No significant preoperative and postoperative changes in other plaque characteristics were found.Conclusion:EVT treatment could compromise the characteristics of intracranial periarterial atherosclerotic plaques,and DCB treatment may result in a reduction in plaque enhancement after treatment.展开更多
文摘目的探讨3D高分辨率磁共振成像(HRMRI)评估症状性基底动脉粥样硬化性重度狭窄重构模式的价值。方法搜集2015年1月至2017年12月经颅脑磁共振血管造影(MRA)显示症状性基底动脉重度狭窄(70～99%)的患者44例,使用VISTA技术对颅内动脉进行轴位扫描,获得容积数据进行后处理重建,得到基底动脉最窄层面、近端参考层面的短轴横断面图像,并分别测量其血管面积和管腔面积,计算重构指数(RI)(最窄层面血管面积/参考层面血管面积),RI≥1为阳性重构,RI<1为阴性重构。然后比较阳性重构和阴性重构组之间临床资料及血管参数的差异。结果 2例患者因图像质量差而被排除,最终42例患者纳入分析。其中22例(52.4%)为阳性重构,20例(47.6%)为阴性重构。在最窄层面,阳性重构组比阴性重构组有更大的血管面积、管壁面积、斑块面积及斑块负荷(P均<0.05)。临床基线数据无统计学差异(P均>0.05)。结论 3D HRMRI可以准确评估症状性基底动脉粥样硬化性狭窄的血管重构模式,具有重要的临床意义。
基金funded by the Beijing Hospital Clinical Research 121 Project(BJ-2018-086 and BJ-2018-202)Capital’s Funds for Health Improvement and Research(2020-4-4053)
文摘Background:Endovascular treatment(EVT)is an alternative option for symptomatic intracranial atherosclerotic disease(ICAD).However,the effect of EVT treatment on ICAD plaques is still unclear.This study describes the ICAD plaque characteristics after EVT treatment and analyzes the effect of different EVT treatments on plaque characteristics.Method:From 2017 January to 2022 January,ICAD patients who underwent endovascular treatment and had follow-up high-resolution magnetic resonance image(HRMRI)were enrolled in the study.Multiple plaque characteristics,including plaque enhancement,plaque burden,were measured based on preoperative,and follow-up HRMRI.Plaque characteristics and postoperative plaque changes were analyzed between different treatment groups.Result:Finally,50 intracranial atherosclerotic plaques in 45 patients were included.Including 28 male patients and 17 female,media age 63.0 years old.Among 50 plaques,41 received percutaneous angioplasty(including 22 plain balloons and 19 drug-coated balloons(DCB))and the other 9 underwent stenting.Stenosis rate,plaque burden and eccentricity index at the lesion site were significantly decreased after EVT compared with preoperative periods(p<0.001).And only the DCB group showed a significant reduction in plaque enhancement at follow-up(p<0.001).No significant preoperative and postoperative changes in other plaque characteristics were found.Conclusion:EVT treatment could compromise the characteristics of intracranial periarterial atherosclerotic plaques,and DCB treatment may result in a reduction in plaque enhancement after treatment.
