Department of Medical Image Center, Tongling People's Hospital, Bijiashan Road 468, Tongling, 244000, Anhui, China.
Department of Neurology, Tongling People's Hospital, Bijiashan Road 468, Tongling, 244000, Anhui, China.
BMC Cardiovasc Disord. 2023 Mar 30;23(1):173. doi: 10.1186/s12872-023-03199-7.
This study aimed to investigate the correlation between the high-risk characteristics of high-resolution MRI carotid vulnerable plaques and the clinical risk factors and concomitant acute cerebral infarction (ACI).
Forty-five patients diagnosed with a single vulnerable carotid plaque by MRI were divided into two groups based on whether they had ipsilateral ACI. The clinical risk factors and the observation values or frequency of occurrence of high-risk MRI phenotypes of plaque volume, LRNC, IPH and ulcer were statistically compared between the two groups.
A total of 45 vulnerable carotid artery plaques were found in 45 patients, 23 patients with ACI and 22 patients without ACI. There were no significant differences in age, sex, smoking, serum TC, TG and LDL between the two groups (all P > 0.05), but the ACI group had significantly more patients with hypertension (P < 0.05) and the without ACI group coronary heart disease (P < 0.05). The volume of vulnerable carotid plaque in the group with ACI (1004.19 ± 663.57 mm3) was significantly larger than that in the group without ACI (487.21 ± 238.64 mm3) (P < 0.05). The phenotype of vulnerable carotid artery plaque was 13 cases of LRNC, 8 cases of LRNC + IPH, 5 cases of LRNC + Ulcer, and 19 cases of LRNC + IPH + Ulcer. There was no significant difference in this distribution between the two groups (all P > 0.05) with the exception of LRNC + IPH + Ulcer. The 14 cases of LRNC + IPH + LRNC + IPH + Ulcer (60.87%) in the group with ACI and was significantly greater than the 5 (22.73%) in patients without ACI (P < 0.05).
It is preliminarily thought that hypertension is the main clinical risk factor for vulnerable carotid plaques with ACI and the combination of plaque volume with vulnerable carotid plaque and LRNC + IPH + Ulcer is a high-risk factor for complicated ACI. It has high clinical therapeutic value due to the accurate diagnosis of responsible vessels and plaques with high-resolution MRI.
本研究旨在探讨高分辨率 MRI 颈动脉易损斑块的高危特征与临床危险因素及伴发急性脑梗死（ACI）之间的相关性。
将 MRI 诊断为单发易损颈动脉斑块的 45 例患者分为有同侧 ACI 组和无同侧 ACI 组，比较两组患者的临床危险因素及斑块容积、LRNC、IPH 和溃疡等高危 MRI 表型的观察值或发生率。
共发现 45 例患者的 45 个易损颈动脉斑块，其中 23 例发生 ACI，22 例无 ACI。两组患者的年龄、性别、吸烟、血清 TC、TG 和 LDL 比较差异均无统计学意义（均 P>0.05），但 ACI 组高血压患者明显多于无 ACI 组（P<0.05），无 ACI 组冠心病患者明显多于 ACI 组（P<0.05）。ACI 组易损颈动脉斑块容积（1004.19±663.57）mm3明显大于无 ACI 组（487.21±238.64）mm3（P<0.05）。易损颈动脉斑块的表型为 13 例 LRNC、8 例 LRNC+IPH、5 例 LRNC+溃疡、19 例 LRNC+IPH+溃疡。两组间这种分布无显著差异（均 P>0.05），但 LRNC+IPH+溃疡除外。ACI 组的 LRNC+IPH+溃疡（60.87%）明显多于无 ACI 组的 5 例（22.73%）（P<0.05）。
初步认为高血压是伴有 ACI 的易损颈动脉斑块的主要临床危险因素，斑块容积与易损颈动脉斑块及 LRNC+IPH+溃疡的联合是并发 ACI 的高危因素。高分辨率 MRI 对责任血管和斑块的准确诊断具有较高的临床治疗价值。
