摘要
目的探讨大脑中动脉斑块特征对急性脑梗死患者预后的预测价值。方法在我院进行诊疗的急性脑梗死患者130例,出院3个月后根据改良Rankin评分(mRS)将患者分为预后良好组(mRS≤2分,n=75)和预后不良组(mRS>2分,n=55)。收集患者高分辨核磁共振成像下大脑中动脉的斑块特征,绘制受试者工作特征曲线(ROC)分析其大脑中动脉斑块负荷及成分对急性脑梗死患者预后的评估作用。结果预后良好组的平均管壁面积、最大管壁厚度以及管壁体积百分比指标均低于预后不良组(P<0.05);MRI检测,预后良好组68支大脑中动脉存在明确斑块,预后不良组50支大脑中动脉存在明确斑块,预后不良组中存在脂质核心、斑块内出血及纤维帽破裂的例数明显多于预后良好组(P<0.05);ROC曲线发现,大脑中动脉的斑块负荷指标(平均管壁面积、最大管壁厚度以及管壁体积百分比)和成分指标(存在脂质核心、斑块内出血及纤维帽破裂)均对急性脑梗死患者预后有明显的评估价值(P<0.05)。结论利用高分辨核磁共振成像技术评估大脑中动脉斑块的负荷及成分对急性脑梗死患者预后具有一定的评估价值。
Objective To investigate the predictive value of middle cerebral artery(MCA)plaque characteristics for the prognosis of patients with acute cerebral infarction(ACI).Methods One hundred and thirty patients with ACI who were treated in our hospital were randomly selected.The patients were divided into good prognosis group(MRS≤2 points,n=75)and poor prognosis group(MRS>2 points,n=55)according to the modified Rankin score(MRS)after three months of discharge.The plaque characteristics of MCA in all patients were collected under high-resolution magnetic resonance imaging.The receiver operating characteristic curve(ROC)was drawn to analyze the effect of plaque load and composition of MCA on the prognosis of patients with acute cerebral infarction.Results Compared with the two groups,the average wall area,the maximum wall thickness and the percentage of tube wall volume in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).After MRI examination,68 MCA had clear plaques in the good prognosis group,and 50 MCA had clear plaques in the poor prognosis group.The number of cases with lipid core,intra plaque hemorrhage and fibrous cap rupture in the poor prognosis group was significantly more than that in the good prognosis group(P<0.05).The ROC curve analysis showed that plaque load index such as mean wall area,maximum wall thickness and percentage of wall volume and component index such as presence of lipid core,intra plaque hemorrhage and rupture of fibrous cap of CMA had significant prognostic value for patients with ACI(P<0.05).Conclusion Using high-resolution magnetic resonance imaging to evaluate the burden and composition of MCA plaque has a certain value in evaluating the prognosis of patients with ACI.
作者
蒋婷
夏春潮
崔福涛
邓双
陈长春
JIANG Ting;XIA Chun-chao;CUI Fu-tao;DENG Shuang;CHEN Chang-chun(Department of Nuclear Medicine,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,China)
出处
《实用医院临床杂志》
2021年第3期122-124,共3页
Practical Journal of Clinical Medicine
关键词
急性脑梗死
大脑中动脉
高分辨核磁共振成像
斑块
预后
评估
Acute cerebral infarction
Middle cerebral artery
High resolution magnetic resonance imaging
plaque
Prognosis
Evaluation
