Page 77 - 磁共振成像2024年7期电子刊

临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

颈动脉高分辨磁共振血管壁成像对缺血性

脑卒中发生及复发诊断价值的Meta分析

*
罗彤，高阳 ，吴琼，何金龙，王泽华

作者单位 内蒙古医科大学附属医院影像诊断科，呼和浩特 010050
* 通信作者 高阳，E-mail: 1390903990@qq.com
中图分类号 R445.2；R743.3 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.012
本文引用格式 罗彤, 高阳, 吴琼, 等 . 颈动脉高分辨磁共振血管壁成像对缺血性脑卒中发生及复发诊断价值的 Meta分析[J]. 磁共
振成像, 2024, 15(7): 70-75.
[摘要] 目的 基于 Meta 分析颈动脉高分辨磁共振血管壁成像对缺血性脑卒中发生及复发的诊断价值。材料与方法 检索
Web of Science、Embase、The Cochrane Library、Medline、PubMed、中国知网、万方、维普数据库中发表的高分辨磁共振血管
壁成像（high-resolution magnetic resonance vessel wall imaging, HR-VWI）评估缺血性脑卒中发生及复发的相关研究，检索时间
为建库至 2024年 2月。根据纳入和排除标准筛选文献。使用固定效应模型计算和合并不同颈动脉易损斑块特征的比值比（odds
ratio, OR）或风险比（hazard ratio, HR），以 Stata 17.0 和 RevMan 5.6 进行 Meta 分析。结果 17 篇文章符合纳入标准。在 8 项回
顾性研究中，斑块内出血（OR=1.92，95% CI：1.46~2.52）、斑块富含脂质的坏死核（OR=2.78，95% CI：1.84~4.18）、斑块钙
化（OR=1.26，95% CI：0.99~1.61）、斑块纤维帽破裂（OR=1.64，95% CI：1.06~2.52）与缺血性脑卒中发生显著相关；在 9 项
前瞻性研究中，斑块内出血（HR=6.88，95% CI：4.46~10.61）、斑块富含脂质的坏死核（HR=1.78，95% CI：0.87~3.65）、斑块
纤维帽破裂（HR=3.01，95% CI：1.53~5.93）与缺血性脑卒中复发显著相关。结论 HR-VWI 可以准确评估颈动脉斑块成分特
征，这些特征与缺血性脑卒中发生及复发有显著相关性。由于缺乏原始研究，未来需要对颈动脉斑块进行大样本量的队列研
究，通过对颈动脉粥样硬化斑块特征的评估，进一步提供缺血性脑卒中发生及复发的早期精准预测和临床治疗指导。
[关键词] 脑卒中；卒中复发；磁共振成像；血管壁成像；颈动脉斑块；Meta分析

Meta analysis of the diagnostic value of carotid artery high-resolution magnetic resonance vessel
wall imaging in the occurrence and recurrence of ischemic stroke

*
LUO Tong, GAO Yang , WU Qiong, HE Jinlong, WANG Zehua
Department of Imaging Diagnosis, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
* Correspondence to GAO Y, E-mail: 1390903990@qq.com
Received 26 Feb 2024, Accepted 6 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.012
ACKNOWLEDGMENTS Natural Science Foundation of Inner Mongolia Autonomous Region (No. 2023QN08055); Healthcare and
Technology Plan Project of Inner Mongolia Autonomous Region (No. 202201250).
Cite this article as LUO T, GAO Y, WU Q, et al. Meta analysis of the diagnostic value of carotid artery high-resolution magnetic resonance
vessel wall imaging in the occurrence and recurrence of ischemic stroke[J]. Chin J Magn Reson Imaging, 2024, 15(7): 70-75.
Abstract Objective: To analyze the diagnostic value of high-resolution magnetic resonance vascular wall imaging (HR-VWI) of the carotid
artery for the occurrence and recurrence of ischemic stroke based on Meta. Materials and Methods: Retrieve relevant studies on HR-VWI
assessment of ischemic stroke occurrence and recurrence published in Web of Science, Embase, The Cochrane Library, Medline, PubMed,
China National Knowledge Network, Wanfang, and VIP database, with a search period from database establishment to February 2024. Select
literature based on inclusion and exclusion criteria. Use a fixed effects model to calculate and combine the odds ratio (OR) or hazard ratio (HR)
of different vulnerable carotid plaque features, and conduct meta-analysis using Stata 17.0 and RevMan 5.6. Results: Seventeen articles met the
inclusion criteria. In 8 retrospective studies, intraplaque hemorrhage (OR=1.92, 95% CI: 1.46-2.52), lipid-rich necrotic nucleus (OR=2.78, 95% CI:
1.84-4.18), plaque calcification (OR=1.26, 95% CI: 0.99-1.61) and fibrous cap rupture (OR=1.64, 95% CI: 1.06-2.52) were significantly
associated with ischemic stroke. In nine prospective studies, intraplaque hemorrhage (HR=6.88, 95% CI: 4.46-10.61), lipid-rich necrotic
nucleus (HR=1.78, 95% CI: 0.87-3.65), fibrous cap rupture (HR=3.01, 95% CI: 1.53-5.93) were significantly associated with ischemic stroke
recurrence. Conclusions: HR-VWI can accurately evaluate the characteristics of carotid artery plaque components, which are significantly
related with the occurrence and recurrence of ischemic stroke. Due to the lack of original research, a large sample size cohort study of carotid
plaque is needed in the future to further provide timely accurate prediction of the occurrence and recurrence of ischemic stroke and guide
clinical treatment by assessing the characteristics of carotid atherosclerotic plaque.
Key words stroke; stroke recurrence; magnetic resonance imaging; vascular wall imaging; vulnerable plaque; Meta analysis

[2]
0 引言 社会影响 。动脉粥样硬化是缺血性脑卒中的重要
缺血性脑卒中具有较高的复发率、致残率和死 病理基础，其中 30% 是由颈动脉粥样硬化性疾病引
亡率，严重威胁人类的生存和健康 。超过 20% 的缺 起的 [3-4] 。既往研究表明，缺血性脑卒中的发生主要
[1]
血性脑卒中患者在 5年内复发，并会造成更广泛的脑 与颈动脉粥样硬化斑块引起的管腔狭窄有关，但最
血管损伤，导致额外的身体和认知障碍以及重大的 近的研究表明，即使有轻度颈动脉管腔狭窄，许多患

收稿日期 2024-02-26 接受日期 2024-07-06
基金项目 内蒙古自治区自然科学基金项目（编号：2023QN08055）；内蒙古自治区医疗卫生科技计划项目（编号：202201250）

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