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高分辨率磁共振成像在评估缺血性脑卒中患者颈动脉粥样硬化斑块中的预后价值

Prognostic value of high-resolution magnetic resonance imaging in evaluating carotid atherosclerotic plaque in patients with ischemic stroke.

作者信息

Shu Jin-Er, Ying Ming-Liang, Chen Xiao-Rong, Hua Jian-Jun, Fu Jie-Ting, Xia Xiu-Mei, Pan Yong-Hao, Jiang Yang

机构信息

Department of Radiology, Jinhua Hospital of Zhejiang University, Jinhua, P.R. China.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8515. doi: 10.1097/MD.0000000000008515.

Abstract

BACKGROUND

Ischemic stroke (IS) is a devastating occurrence affecting millions worldwide. This study aimed to evaluate the prognostic value of high-resolution magnetic resonance imaging (HRMRI) in assessing carotid atherosclerotic plaque in IS patients.

METHODS

Between January 2013 and March 2015, 338 IS patients were recruited for the investigative purposes of the study. All participants of the study underwent an HRMRI inspection procedure after being admitted into the hospital. During this study, we systematically analyzed and measured various types of fibrous caps, lipid compositions, and plaque lipid ratios. Univariate and multivariate logistic regression analyses were performed for predicting prognosis of IS patients. A receiver-operating characteristic (ROC) curve was employed to determine the accuracy of the IS prognosis.

RESULTS

The percentage of type I fibrous caps exhibited significant decrease, while the percentage of type III fibrous caps, lipid compositions, and lipid ratios all displayed increase. The results of the univariate analysis indicated that age, hypertension, hyperlipidemia, treatment regimens, fibrous cap type, plaque type, lipid composition, and lipid ratio shared a correlation in regards to the poor prognosis of IS patients. Multivariate logistic regression analysis demonstrated that the prognosis of IS patients was not necessarily dependent on fibrous cap type, plaque type, or age. ROC curves revealed that the HRMRI possessed a strong predicative ability in relation to the identification of the prognosis of IS patients through factors such as type of plaque and fibrous caps determination.

CONCLUSION

Our study conclusively intimated the promise of HRMRI as an evaluative tool for the determination of carotid atherosclerotic plaques in patients with IS.

摘要

背景

缺血性中风(IS)是一种严重的疾病,影响着全球数百万人。本研究旨在评估高分辨率磁共振成像(HRMRI)在评估IS患者颈动脉粥样硬化斑块方面的预后价值。

方法

在2013年1月至2015年3月期间,招募了338例IS患者用于本研究的调查目的。所有研究参与者入院后均接受了HRMRI检查程序。在本研究中,我们系统地分析和测量了各种类型的纤维帽、脂质成分和斑块脂质比率。进行单变量和多变量逻辑回归分析以预测IS患者的预后。采用受试者操作特征(ROC)曲线来确定IS预后的准确性。

结果

I型纤维帽的百分比显著降低,而III型纤维帽的百分比、脂质成分和脂质比率均显示增加。单变量分析结果表明,年龄、高血压、高脂血症、治疗方案、纤维帽类型、斑块类型、脂质成分和脂质比率与IS患者预后不良相关。多变量逻辑回归分析表明,IS患者的预后不一定取决于纤维帽类型、斑块类型或年龄。ROC曲线显示,HRMRI通过斑块类型和纤维帽确定等因素在识别IS患者预后方面具有很强的预测能力。

结论

我们的研究最终表明HRMRI有望作为一种评估工具,用于确定IS患者的颈动脉粥样硬化斑块。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b290/5690746/c3f4611dd05f/medi-96-e8515-g002.jpg

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