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高分辨率磁共振成像上有症状斑块的特征及其与缺血性卒中发生和复发的关系。

Characteristics of symptomatic plaque on high-resolution magnetic resonance imaging and its relationship with the occurrence and recurrence of ischemic stroke.

机构信息

Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu Province, China.

Department of Neurology, The People's Hospital of Suzhou New District, No. 95, Huashan Road, Suzhou, Jiangsu Province, China.

出版信息

Neurol Sci. 2021 Sep;42(9):3605-3613. doi: 10.1007/s10072-021-05457-y. Epub 2021 Jul 8.

Abstract

BACKGROUND

Atherosclerosis is the most common cause of ischemia stroke. Computed tomographic angiography (CTA) and digital subtraction angiography (DSA) are used to evaluate the degree of lumen stenosis. However, these examinations are invasive and can only reveal mild to moderate stenosis. High-resolution magnetic resonance imaging (HRMRI) seems a more intuitive way to show the pathological changes of vascular wall. Hence, we conducted a systematic retrospective study to determine the characteristics of symptomatic plaques in patients with intracranial atherosclerosis on HRMRI and their association with the occurrence and recurrence of ischemic stroke events.

METHODS

The PubMed database was searched for relevant studies reported from January 31, 2010, to October 31, 2020.

RESULTS

We selected 14 clinical outcome studies. We found that plaque enhancement and positive remodeling on HRMRI indicate symptomatic plaques. Besides, intraplaque hemorrhage and positive remodeling index are closely related to the occurrence of stroke. However, it is still controversial whether the initial enhancement of plaque and the occurrence and recurrence of stroke are related. There is also no significant correlation between vascular stenosis and symptomatic plaque or the occurrence and recurrence of ischemic stroke.

CONCLUSION

High-resolution magnetic resonance imaging can be used as an assessment tool to predict the risk of stroke onset and recurrence in patients with atherosclerosis, but further research is also needed.

摘要

背景

动脉粥样硬化是缺血性脑卒中最常见的病因。计算机断层血管造影(CTA)和数字减影血管造影(DSA)用于评估管腔狭窄程度。然而,这些检查具有侵入性,只能发现轻度至中度狭窄。高分辨率磁共振成像(HRMRI)似乎是一种更直观的方法,可以显示血管壁的病理变化。因此,我们进行了一项系统的回顾性研究,以确定 HRMRI 上颅内动脉粥样硬化患者症状性斑块的特征及其与缺血性脑卒中事件发生和复发的关系。

方法

在 PubMed 数据库中搜索了 2010 年 1 月 31 日至 2020 年 10 月 31 日期间发表的相关研究。

结果

我们选择了 14 项临床预后研究。我们发现,HRMRI 上的斑块增强和正性重构提示症状性斑块。此外,斑块内出血和正性重构指数与脑卒中的发生密切相关。然而,斑块初始增强与脑卒中的发生和复发是否相关仍存在争议。血管狭窄与症状性斑块或缺血性脑卒中的发生和复发之间也没有显著相关性。

结论

高分辨率磁共振成像可作为评估工具,预测动脉粥样硬化患者脑卒中发病和复发的风险,但还需要进一步研究。

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