In vivo identification of complicated upper thoracic aorta and arch vessel plaque by MR direct thrombus imaging in patients investigated for cerebrovascular disease
In vivo identification of complicated upper thoracic aorta and arch vessel plaque by MR direct thrombus imaging in patients investigated for cerebrovascular disease
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DOI：
10.2214/ajr.05.1556
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发表时间：
2006-07-01
影响因子：
5
通讯作者：
Maggisano, Robert
中科院分区：
文献类型：
--
作者：
Bitar, Richard;Moody, Alan R.;Maggisano, Robert
OBJECTIVE.本文的目的是评估MR直接血栓成像（MRDTI）的可行性，以评估复杂的上胸主动脉和弓状血管斑块的患病率和位置的患者提到的评价脑血管疾病。入组接受MRI脑血管疾病检查的患者。转诊原因包括短暂性脑缺血发作/一过性黑蒙、急性梗死、远端梗死或无症状颈动脉疾病。在最初扫描的348名患者中，17名被排除在分析之外。最终患者人群包括331例患者（199例男性，132例女性;平均年龄67.7岁）。使用MRDTI扫描患者，MRDTI是一种313，T1加权，脂肪抑制的破坏梯度回波，利用高铁血红蛋白的T1缩短效应，直接可视化血管壁中的出血/血栓，从而识别复杂斑块。复杂斑块是指动脉粥样硬化斑块内的高信号，至少是肌肉信号强度的两倍。331例患者中有43例（13%）患有复杂的上胸主动脉粥样硬化性疾病、弓状血管粥样硬化性疾病或两者兼而有之。上胸主动脉受累36例（83.7%），左锁骨下动脉受累14例（32.6%）。43例患者中有1例（2.3%）同时累及右锁骨下动脉和头臂动脉。43例患者中有25例（58.1%）出现复杂的颈动脉斑块。MRDTI可用于检测上胸主动脉及弓状血管的复杂斑块。在13%的患者人群中发现了复杂斑块。上胸主动脉是最常见的受累部位。这项技术可能是有用的无症状的高危患者的筛选。
OBJECTIVE. The objective of this article was to assess the feasibility of MR direct thrombus imaging (MRDTI) to evaluate the prevalence and location of complicated upper thoracic aortic and arch vessel plaque in patients referred for evaluation of cerebrovascular disease.SUBJECTS AND METHODS. Patients referred for investigation of cerebrovascular disease by MRI were enrolled. Reasons for referral included transient ischemic attack/amaurosis fugax, acute infarct, remote infarct, or asymptomatic carotid disease. Of the 348 patients initially scanned, 17 were excluded from the analysis. The final patient population included 331 patients (199 men, 132 women; mean age, 67.7 years). Patients were scanned using MRDTI, a 313, T1-weighted, fat-suppressed spoiled gradient echo that exploits the T1 shortening effects of methemoglobin, directly visualizing hemorrhage/thrombus in the vessel wall, thus identifying complicated plaque. Complicated plaque was defined as a high signal within the atherosclerotic plaque at least twice the signal intensity of muscle.RESULTS. Forty-three of 331 patients (13%) had complicated upper thoracic aortic atherosclerotic disease, arch vessel atherosclerotic disease, or both. The upper thoracic aorta was involved in 36 of 43 patients (83.7%), and the left subclavian artery was involved in 14 of 43 patients (32.6%). Both the right subclavian artery and the brachiocephalic artery were involved in one of 43 patients (2.3%). Complicated carotid plaque was seen in 25 of 43 patients (58.1%).CONCLUSION. MRDTI can be applied in the detection of complicated plaque in the upper thoracic aorta and arch vessels. Complicated plaque was identified in 13% of the patient population. The upper thoracic aorta was the most common site involved. This technique could be useful for the screening of asymptomatic at-risk patients.