Department of Radiology, Utah Center for Advanced Imaging Research, University of Utah School of Medicine, Salt Lake City, UT 84132-2140, USA.
Circ Cardiovasc Imaging. 2012 May 1;5(3):376-82. doi: 10.1161/CIRCIMAGING.111.967398. Epub 2012 Apr 11.
Carotid intraplaque hemorrhage has been associated with symptomatic stroke and can be accurately detected with magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Currently, there are no studies analyzing carotid MPRAGE signal and territorial ischemic events defined by diffusion restriction in the acute setting. Our aim was to determine the association of carotid MPRAGE signal with acute territorial ischemic events using carotid MPRAGE and brain diffusion tensor imaging.
After the addition of the MPRAGE sequence to the neck MR angiographic protocol, 159 patients with suspected acute stroke were evaluated with both brain diffusion tensor imaging and carotid MPRAGE sequences over 2 years, providing 318 carotid artery and paired brain images for analysis. Forty-eight arteries were excluded due to extracarotid sources of brain ischemia and 4 were excluded due to carotid occlusion. Two hundred sixty-six arteries were eligible for data analysis. Carotid MPRAGE-positive signal was associated with an acute cerebral territorial ischemic event with a relative risk of 6.4 (P<0.001). The relative risk of a diffusion tensor imaging-positive territorial ischemic event with carotid MPRAGE-positive signal was increased in mild, moderate, and severe stenosis categories (10.3, P<0.001; 2.9, P=0.01; and 2.2, P=0.01, respectively).
In the workup of acute stroke, carotid MPRAGE-positive signal was associated with an increased risk of territorial cerebral ischemic events as detected objectively by brain diffusion tensor imaging. The relative risk of stroke was increased in all carotid stenosis categories but was most elevated in the mild stenosis category.
颈动脉斑块内出血与症状性中风有关，可通过磁化准备快速获取梯度回波（MPRAGE）准确检测。目前，尚无研究分析颈动脉 MPRAGE 信号与急性扩散受限定义的区域性缺血事件之间的关系。我们的目的是使用颈动脉 MPRAGE 和脑弥散张量成像来确定颈动脉 MPRAGE 信号与急性区域性缺血事件的相关性。
在颈部磁共振血管造影方案中添加 MPRAGE 序列后，在 2 年内对 159 例疑似急性中风的患者进行了脑弥散张量成像和颈动脉 MPRAGE 序列评估，提供了 318 条颈动脉和配对脑图像进行分析。由于脑缺血的颅外来源，48 条动脉被排除在外，由于颈动脉闭塞，4 条动脉被排除在外。266 条动脉符合数据分析条件。颈动脉 MPRAGE 阳性信号与急性脑区域性缺血事件相关，相对风险为 6.4（P<0.001）。颈动脉 MPRAGE 阳性信号与弥散张量成像阳性区域性缺血事件的相对风险在轻度、中度和重度狭窄类别中增加（10.3，P<0.001；2.9，P=0.01；2.2，P=0.01）。
在急性中风的检查中，颈动脉 MPRAGE 阳性信号与脑弥散张量成像客观检测到的区域性脑缺血事件的风险增加相关。在所有颈动脉狭窄类别中，中风的相对风险增加，但在轻度狭窄类别中增加最为明显。
