Diagnostic Value Of HR-MRI And Ultrasonography In The Diagnosis Of Carotid Atherosclerotic Plaque

Purpose:To evaluate High resolution magnetic resonance imaging and ultrasound diagnostic value of carotid atherosclerotic plaques.Methods:By ultrasound diagnosis of 40 cases of mild carotid stenosis patients,including 23 cases of male,female 17 cases,average age(67.2 + 10.2)years old,the age > 70 years old 1 cases;30 cases of hypertension,5 cases of coronary heart disease,9 cases of diabetes,carotid artery,external carotid artery and carotid artery were 240 vessel for carotid bifurcation for High resolution magnetic resonance imaging carotid plaque MRI sequence scanning,analysis of carotid atherosclerotic plaque,plaque and stenosis;comparison of high resolution difference between High resolution magnetic resonance imaging and ultrasound examination of the carotid artery plaque,plaque morphology,properties and luminal stenosis.Exclusion criteria: if the object of study to meet the following one,are not included in this study:(1)with severe cardiac insufficiency or heart failure,acute coronary blood vessels and unstable angina,myocardial infarction,arrhythmia(atrial fibrillation)of poorly controlled;2.The liver,kidney function is not complete(serum creatinine > 178(including mol/L,GFR < 29 ml/min;hepatic transaminase > 2 times the upper limit of normal).3.A history of bleeding in the brain;4.Has a history of convulsions,seizures and myopathy;5.The body is equipped with is not suitable for magnetic resonance imaging for the metal foreign body or pacemakers,etc.;Patients with mental disorders and claustrophobic.Results:1.High resolution magnetic resonance imaging has a good display on carotid atherosclerotic plaque plaque and the plaque,this group of carotid atherosclerotic plaque in MRI showed circular or eccentric wall thickening,with or without local crescent or half moon signal protruding into the lumen,because each patch containing different components,and can also contain a variety of the MRI components are different.Plaque lipid composition was isointense on 3D-TOF images,T1 WI,PDWI was isointense or slightly low signal,T2 WI showed slightly low signal,lipid necrosis increased after the signal sequence is point;calcification strip low signal;plaque fresh hemorrhage in all sequences were high signal;fiber cap complete zonal low signal in 3D-TOF and showed equal or high signal on T1 WI,PDWI,T2 WI,occurrence of fibrous cap rupture,can display 3D-TOF like low signal with complete lack of fibrous cap break and lumen interlinked;fiber plaques in 3D-TOF as equal or slightly low signal,T1 WI,PDWI is equal or slightly high signal on T2 WI and slightly high signal.2.Comparison of carotid artery ultrasonography and High resolution magnetic resonance imaging in the degree of arterial stenosis and plaque2.1 The degree of carotid artery ultrasonography stenosis assessment and High resolution magnetic resonance imaging serious side of carotid artery stenosis: mild stenosis were 12 and 13 branches,mild to moderate stenosis were 42 and 40 branches,severe stenosis were 16 and 17,total occlusion were 4 branches and 4 branches.Ultrasound assessment of accuracy and the degree of stenosis of the High resolution magnetic resonance imaging comparison,the difference was not statistically significant(P <0.05).2.2 High resolution magnetic resonance imaging of carotid artery wall morphology and plaque composition and carotid artery ultrasound in carotid artery ultrasound examination showed hard spots and even low echo lipid plaques are equivalent to the II and III type,large hypoechoic and heterogeneous mixed plaque is equivalent to IV-V,carotid artery plaque 38,IV type-V 16 type VI plaque,plaque 22;carotid artery ultrasound detected 26 vulnerable plaques,12 suspected vulnerable plaque,after confirmed by High resolution magnetic resonance imaging vulnerable plaque,and the detection of ultrasound on vulnerable plaques,c2=3.95,P<0.05,the difference was statistically significant(c2 test,P<0.05).3.The distribution of various types of plaques: the image quality of 40 cases of patients with High resolution magnetic resonance examination were consistent with the research requirements,found a total of 74 carotid atherosclerotic plaque,which I-II type accounted for 12.1%,accounted for 23% of type III,IV-V type VI type accounted for 21.6%,accounting for 29.7%,accounting for 13.5% of type viii.The specific distribution of each type of plaque see table 3.The results showed that c2=11.25,P>0.05,there was no significant difference in the distribution of vulnerable plaques and stable plaques in 3 parts of carotid artery(c2 test,P< 0.05).Conclution:1.High resolution magnetic resonance imaging can clearly show that carotid atherosclerotic plaques plaque composition,degree of luminal stenosis,determine plaque vulnerability.2.High resolution magnetic resonance imaging of carotid atherosclerotic plaques plaque properties in the ultrasound has obvious superiority.