Distribution and features of middle cerebral artery atherosclerotic plaques in symptomatic patients: a 3.0 T high-resolution MRI study
Distribution and features of middle cerebral artery atherosclerotic plaques in symptomatic patients: a 3.0 T high-resolution MRI study
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DOI：
10.1179/1743132815y.0000000023
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发表时间：
2015-05-01
影响因子：
1.9
通讯作者：
Qin, Haiqiang
中科院分区：
文献类型：
--
作者：
Sui, Binbin;Gao, Peiyi;Qin, Haiqiang
目的：应用高分辨率磁共振成像(MR)研究急性缺血性卒中患者大脑中动脉(MCA)斑块的分布和特点。方法：对急性症状性缺血性卒中患者大脑中动脉(MCA)44个斑块(右侧18个，左侧26个)的46个斑块进行研究。高分辨率磁共振成像包括T1加权像(T1WI)、T2加权像(T2WI)、PD加权像(PDWI)和三维磁化准备快速采集梯度回波(MPRAGE)序列。在斜矢状图上，斑块的位置可分为大脑中动脉腹壁、远端、上壁和下壁。记录斑块的厚度、面积和信号强度。结果：46块斑块中，位于腹壁26块(56.5%)，背壁6块(13.0%)，上壁9块(19.6%)，下壁5块(10.9%)。斑块厚度和面积分别为1.37±0.53 mm(0.61~3.20 mm)和3.80±2.13 mm(2)(1.01~12.2 mm(2))。不同部位间斑块厚度(P=0.464)、斑块面积(P=0.107)、狭窄程度(P=0.563)差异无统计学意义。多数斑块(44/46)在T1WI上呈等信号。在T2W I和PDW I上，24个斑块呈等信号，12个斑块呈稍高信号，8个斑块呈稍低信号。2个斑块内出血，在T1WI和MP-RAGE上呈高信号，在T2WI和PDWI上呈高或混合信号。斑块的分布和特征揭示了斑块形成的一些特点，有助于了解缺血事件的潜在机制。
Objectives: To investigate the distribution and features of middle cerebral artery (MCA) atherosclerotic plaques in patients with acute ischaemic strokes using high-resolution magnetic resonance (MR) imaging.Methods: Forty-six plaques from 44 MCAs (18 right and 26 left) in patients with acute symptomatic ischaemic strokes were studied. High-resolution MR imaging including T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), PD weighted imaging (PDWI) and three-dimensional magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequences were used to visualise the plaques. The locations of plaques were classified into ventral, distal, superior and inferior wall of the MCA on oblique sagittal images. The thickness, area and signal intensities of plaques were recorded. The stenosis degree of MCA was calculated.Results: Among all 46 plaques, 26 plaques were located at the ventral wall (56.5%), 6 at the dorsal wall (13.0%), 9 at the superior wall (19.6%), and five at the inferior wall (10.9%). The average thickness and area of plaques were 1.37+/-0.53 mm (range: 0.61-3.20 mm) and 3.80+/-2.13 mm(2) (range: 1.01-12.2 mm(2)), respectively. No significant differences in plaque thickness (P=0.464), plaque area (P=0.107) or stenosis degree (P=0.563) were noted between different locations. Most of the plaques (44/46) showed iso-intensity on T1WI. On T2WI and PDWI, 24 plaques showed iso-intensity, 12 plaques showed a slightly high signal intensity (SI), and eight plaques showed a slightly low SI. Intraplaque haemorrhage was found in two plaques, with high SI on T1WI and MP-RAGE and high or mixed SI on T2WI and PDWI.Discussion: Middle cerebral artery plaques in patients with acute infarction have certain tendency to locate at ventral and superior walls. Distribution and features of plaques revealed some plaque formation characteristics and would help to understand underlying mechanisms of ischaemic events.