背景:颅内动脉粥样硬化,中风的主要原因,涉及动脉斑块的形成。本研究使用高分辨率血管壁成像(HR-VWI)探讨了斑块重塑模式与糖尿病之间的联系。
目的:使用HR-VWI研究颅内动脉粥样硬化重塑模式的因素以及颅内动脉粥样硬化重塑与糖尿病的关系。
方法:纳入94例大脑中动脉或基底动脉粥样硬化患者。收集他们的基本临床资料,进行了HR-VWI。使用图像后处理软件描绘和测量斑块处的血管面积(VAMLN)和正常参考血管(VAreference),并计算了改造指数(RI)。根据RI的价值,将患者分为阳性重塑(PR)组,中间重塑(IR)基团,负重塑(NR)组,PR组和非PR(N-PR)组。
结果:PR组的糖尿病患病率和血清胆固醇水平高于IR和NR组[45.2%,4.54(4.16,5.93)vs25%,4.80±1.22和16.4%,4.14(3.53,4.75),分别,P<0.05]。PR组的糖尿病发病率也明显高于N-PR组(45.2%vs17.5%,P<0.05)。此外,与N-PR组相比,PR组血清甘油三酯和胆固醇水平[1.64(1.23,2.33)和4.54(4.16,5.93)vs4.54(4.16,5.93)和4.24(3.53,4.89),P<0.05]。Logistic回归分析显示糖尿病是斑块PR的独立影响因素[比值比(95%置信区间):3.718(1.207-11.454),P<0.05]。
结论:HR-VWI能清晰显示颅内血管壁和血管斑块的形态和信号特征。糖尿病患者颅内动脉粥样硬化斑块更容易显示PR,提示斑块稳定性差,卒中风险较大。
BACKGROUND: Intracranial atherosclerosis, a leading cause of stroke, involves arterial plaque formation. This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging (HR-VWI).
OBJECTIVE: To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.
METHODS: Ninety-four patients diagnosed with middle cerebral artery or basilar artery atherosclerosis were enrolled. Their basic clinical data were collected, and HR-VWI was performed. The vascular area at the plaque (VAMLN) and normal reference vessel (VAreference) were delineated and measured using image postprocessing software, and the Remodelling index (RI) was calculated. According to the value of the RI, the patients were divided into a positive remodelling (PR) group, intermediate remodelling (IR) group, negative remodelling (NR) group, PR group and non-PR (N-PR) group.
RESULTS: The PR group exhibited a higher prevalence of diabetes and serum cholesterol levels than the IR and NR groups [45.2%, 4.54 (4.16, 5.93) vs 25%, 4.80 ± 1.22 and 16.4%, 4.14 (3.53, 4.75), respectively, P < 0.05]. The diabetes incidence was also significantly greater in the PR group than in the N-PR group (45.2% vs 17.5%, P < 0.05). Furthermore, the PR group displayed elevated serum triglyceride and cholesterol levels compared to the N-PR group [1.64 (1.23, 2.33) and 4.54 (4.16, 5.93) vs 4.54 (4.16, 5.93) and 4.24 (3.53, 4.89), P < 0.05]. Logistic regression analysis revealed diabetes mellitus as an independent influencing factor in plaque-PR [odds ratio (95% confidence interval): 3.718 (1.207-11.454), P < 0.05].
CONCLUSIONS: HR-VWI can clearly show the morphology and signal characteristics of intracranial vascular walls and plaques. Intracranial atherosclerotic plaques in diabetic patients are more likely to show PR, suggesting poor plaque stability and a greater risk of stroke.