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高分辨率磁共振血管壁成像评估大脑中动脉狭窄斑块特征与支架内再狭窄的相关性()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年12
页码:
1282-1287
栏目:
神经介入
出版日期:
2024-12-25

文章信息/Info

Title:
High-resolution magnetic resonance angiography for assessing the correlation between plaque characteristics of middle cerebral artery stenosis and in-stent restenosis
作者:
龚宇于淼田甜张继伟胡军崔志新白雪东韩凤伟褚会松王占森呼铁民
Author(s):
GONG YuYU MiaoTIAN TianZHANG JiweiHU JunCUI ZhixinBAI XuedongHAN FengweiCHU HuisongWANG ZhansenHU Tiemin.
Department of Neurosurgery,Affiliated Hospital of Chengde Medical College,Chengde,Hebei Province 067000,China
关键词:
【关键词】高分辨率磁共振血管壁成像大脑中动脉狭窄动脉粥样硬化斑块支架内再狭窄
文献标志码:
A
摘要:
【摘要】目的采用高分辨率磁共振血管壁成像评估大脑中动脉狭窄患者斑块特征与支架术后再狭窄的关系。方法纳入2019年1月至2023年3月就诊于承德医学院附属医院的有症状动脉粥样硬化性大脑中动脉狭窄患者66例。均在支架植入术前完成高分辨率磁共振血管壁成像检查。依据术后影像学随访分为支架内再狭窄组与支架内未狭窄组。比较两组术前影像学评估斑块特征。 结果支架内再狭窄组14例,支架内未狭窄组52例。斑块分布多位于下侧壁(37.8%)和腹侧壁(28.7%),两组差异无统计学意义(P>0.05)。相较于支架内未狭窄组,支架内再狭窄组负性重构(64.2%比28.8%)更高,差异有统计学意义(χ2=6.026,P=0.049);支架内再狭窄组斑块负荷79.09±8.82,支架内未狭窄组为69.46±10.49,差异有统计学意义(t=3.143,P=0.003);支架内再狭窄组同型半胱氨酸偏高为(16.02±4.24)mol/L,支架内未狭窄组为(12.05±3.34)mol/L,差异有统计学意义(t=3.717,P<0.001)。支架内再狭窄组中明显强化斑块更多(78.5%比42.3%),差异有统计学意义(χ2=6.311,P=0.043)。多因素logistic回归分析显示,斑块负荷(OR=1.225,95%CI:1.040~1.443,P=0.015)与同型半胱氨酸(OR=1.676,95%CI:1.150~2.442,P=0.007)是支架内再狭窄的独立危险因素。ROC曲线分析显示,斑块负荷预测支架内再狭窄的AUC=0.765,95%CI:0.622~0.908,P=0.002,特异度0.731,灵敏度0.714;同型半胱氨酸AUC=0.767,95%CI:0.623~0.911,P=0.002,特异度0.942,灵敏度0.500;两者联合的预测效能最佳,AUC=0.887,95%CI:0.794~0.981,P<0.001,特异度0.904,灵敏度0.714。结论斑块负荷和同型半胱氨酸预测支架内再狭窄具有较高的特异度与灵敏度。

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备注/Memo

备注/Memo:
(收稿日期:2023-12-19)
(本文编辑:新宇)
更新日期/Last Update: 2024-12-18