Morphologic Characteristics of Atherosclerotic Middle Cerebral Arteries on 3T High-Resolution MRI
Morphologic Characteristics of Atherosclerotic Middle Cerebral Arteries on 3T High-Resolution MRI
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动脉粥样硬化大脑中动脉的3T高分辨率MRI形态特征
DOI：
10.3174/ajnr.a3573
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发表时间：
2013-09-01
影响因子：
3.5
通讯作者：
Jiang, W. -J.
中科院分区：
文献类型：
--
作者：
Zhu, X. J.;Du, B.;Jiang, W. -J.
背景和目的：关于大脑中动脉粥样硬化性狭窄的形态学特征的研究有限。我们的目的是用3 T高分辨率MR成像定量评估动脉粥样硬化MCA的重塑模式和斑块分布。材料和方法：入选了87例DSA显示MCA M1段有症状性动脉粥样硬化狭窄的连续患者（50%-99%）。重构指数计算为最大管腔狭窄时的血管面积/参考血管面积。重塑指数≥ 1.0定义为正性重塑，重塑指数< 1.0定义为负性重塑。根据MCA壁的上级、下级、背侧或腹侧受累情况对管腔最大狭窄部位的斑块分布进行分类。研究结果：87例患者中有43例因成像质量差（n = 8）或扫描平面不清晰继发于MCA迂曲的M1段或MCA口病变或成角病变（n = 35）而被排除。在44例患者中，19例（43.2%）病变出现负性重塑，25例（56.8%）病变出现正性重塑。在最大管腔狭窄部位，与正性重塑病变相比，负性重塑病变的血管面积、管壁面积和斑块负荷百分比更小（P <0.0001），偏心指数更低（P = 0.023）。44例患者中15例（34.1%）斑块累及上级和背壁。结论：2D高分辨率MR成像可帮助评估MCA狭窄的重塑模式和斑块分布，但在MCA的迂曲过程和MCA口或成角病变中，用于重塑评估的成像和后处理方案需要改进。
BACKGROUND AND PURPOSE: There are limited studies on the morphologic characteristics of MCA atherosclerotic stenosis. Our aim was to quantitatively assess the remodeling pattern and plaque distribution of atherosclerotic MCAs with 3T high-resolution MR imaging. MATERIALS AND METHODS: Eighty-seven consecutive patients with symptomatic atherosclerotic stenoses at the M1 segment of the MCA on DSA (50%–99%) were enrolled. The remodeling index was calculated as the Vessel Area at Maximal Lumen Narrowing/Reference Vessel Area. A remodeling index ≥ 1.0 was defined as positive remodeling, and a remodeling index < 1.0, as negative remodeling. Plaque distribution at the maximal lumen narrowing site was classified on the basis of the involvement of the superior, inferior, dorsal, or ventral MCA wall. RESULTS: Forty-three of 87 patients were excluded due to poor imaging quality (n = 8) or scan plane obliquity secondary to a tortuous M1 segment of the MCA or an MCA ostium lesion or angled lesion (n = 35). Of 44 patients in the final analysis, negative remodeling was found in 19 (43.2%) lesions, and positive remodeling, in 25 (56.8%) lesions. At maximal lumen narrowing sites, lesions with negative remodeling had less vessel area, wall area, and percentage of plaque burden (P < .0001) and a lower eccentricity index (P = .023), compared with lesions with positive remodeling. The plaque involved the superior and dorsal walls in 15 (34.1%) of 44 patients. CONCLUSIONS: 2D high-resolution MR imaging can help assess the remodeling pattern and plaque distribution of MCA stenosis, but the imaging and postprocessing protocol for remodeling assessment needs to be improved in the tortuous course of the MCA and in MCA ostium or angled lesions.