作者：陶剑，陆海凤，顾刚，高水生，陈小宇，石海

单位：

1.223002江苏省淮安市，徐州医科大学附属淮安医院 淮安市第二人民医院影像科　2.223800江苏省宿迁市，徐州医科大学附属宿迁医院影像科　3.225009江苏省扬州市，扬州大学附属医院影像科　4.210000江苏省南京市，南京医科大学第一附属医院影像科

Units：

1.Imaging Department, the Affiliated Huaian Hospital of Xuzhou Medical University/Huai'an Second People's Hospital,Huaian 223002, China2.Imaging Department, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian 223800, China3.Imaging Department, Yangzhou University Affiliated Hospital, Yangzhou 225009, China4.Imaging Department, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China

关键词：

脑缺血发作，短暂性；前循环短暂性脑缺血发作；高分辨率血管壁成像技术

Keywords：

　Ischemic attack, transient; Anterior circulation transient ischemic attack; HR-VWI

CLC：

R 743.31

DOI：

10.12114/j.issn.1008-5971.2023.00.280

Funds：

摘要：

目的　分析高分辨率血管壁成像技术（HR-VMI）在前循环短暂性脑缺血发作频发评估中的应用价值。方法　选取2019年5月至2022年12月南京医科大学第一附属医院收治的前循环短暂性脑缺血发作患者162例为研究对象，按照发作频次将其分为频发组（24 h内发作频次≥2次，n=60）和非频发组（24 h内发作频次＜2次，n=102）。收集两组基线资料，采用HR-VMI检测两组大脑中动脉斑块位置、血管狭窄程度、斑块强化特点（包括强化等级和强化模式）及血管重塑情况。前循环短暂性脑缺血发作频发的影响因素分析采用多因素Logistic回归分析。结果　两组斑块位置、血管狭窄程度、斑块强化等级、斑块强化模式及血管重塑情况比较，差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，斑块位置、血管狭窄程度、斑块强化等级、斑块强化模式及血管重塑情况是前循环短暂性脑缺血发作频发的独立影响因素（P＜0.05）。结论　基于HR-VMI检测的斑块位置、血管狭窄程度、斑块强化等级、斑块强化模式及血管重塑情况是前循环短暂性脑缺血发作频发的独立影响因素。

Abstract：

Objective To analyze the application value of high-resolution vessel wall imaging (HR-VWI) in theevaluation of the frequently happen of anterior circulation transient ischemic attack. Methods A total of 162 patients withanterior circulation transient ischemic attack admitted to the First Affiliated Hospital of Nanjing Medical University from May2019 to December 2022 were selected as the research objects. According to the frequency of attack, they were divided intofrequent group (attack frequency ≥ 2 times within 24 h, n=60) and non-frequent group (attack frequency < 2 times within 24 h,n=102) . The baseline data of the two groups were collected. HR-VMI was used to detect the location of middle cerebral arteryplaque, the degree of vascular stenosis, the characteristics of plaque enhancement (including enhancement grade and enhancementmode) and vascular remodeling in the two groups. Multivariate Logistic regression analysis was used to analyze the influencingfactors of frequently happen of anterior circulation transient ischemic attack. Results There were significant differences inplaque location, degree of vascular stenosis, plaque enhancement grade, plaque enhancement mode and vascular remodelingbetween the two groups (P < 0.05) . Multivariate Logistic regression analysis showed that plaque location, degree of vascularstenosis, plaque enhancement grade, plaque enhancement mode and vascular remodeling were independent influencing factors offrequently happen of anterior circulation transient ischemic attack (P < 0.05) . Conclusion The location of plaque, the degree ofvascular stenosis, the grade of plaque enhancement, the mode of plaque enhancement and vascular remodeling detected based onHR-VMI are independent influencing factors of frequently happen of anterior circulation transient ischemic attack.

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