ĐẶC ĐIỂM HÌNH ẢNH HẸP ĐỘNG MẠCH NỘI SỌ TRÊN CỘNG HƯỞNG TỪ VÀ MỐI LIÊN QUAN VỚI MỘT SỐ YẾU TỐ NGUY CƠ, NGUYÊN NHÂN CỦA HẸP MẠCH MÁU NÃO=Intracranial artery stenosis magnetic resonance imaging and relationship with some risk factors and causes of cerebral vascular stenosis

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hải Hà Đỗ, Quang Anh Nguyễn, Xuân Bách Trần, Đức Ngọc Từ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.56-66

Bộ sưu tập: Báo, Tạp chí

ID: 486880

Thêm vào giỏ

Mục tiêu: Nghiên cứu mô tả đặc điểm hẹp động mạch não trên cộng hưởng từ và mối liên quan với một số yếu tố nguy cơ, nguyên nhân của hẹp mạch não.Phương pháp: Nghiên cứu mô tả cắt ngang, đơn trung tâm, thực hiện trên 104 bệnh nhân có hình ảnh hẹp động mạch nội sọ bằng cộng hưởng từ 3.0 Tesla từ 6/2021 đến tháng 6/2022 tại bệnh viện Bạch Mai, Hà Nội, Việt Nam.Kết quả: Tuổi trung bình là 64,71 ± 14,08, nhóm tuổi ≥60 chiếm tỷ lệ cao nhất 76%, tỉ lệ nam/nữa ~ 2,58:1. Trong tổng số 104 bệnh nhân nghiên cứu, 27 bệnh nhân (26%) có hẹp từ hai loại động mạch hẹp khác nhau trở lên. Bệnh lý hẹp mạch não thường gặp ở hệ tuần hoàn trước (66.4%), tỉ lệ HTHT:HTHS ~ 2:1. Tổn thương gặp nhiều nhất ở ĐMNG và ĐMCT, chiếm tỉ lệ tương ứng là 33,6% - 29,3%, ĐMNT ít tổn thương nhất (5/140
3,6%). Ở HTHT, mức độ hẹp vừa chiếm tỉ lệ cao nhất (33,6%
p=0,008), tỉ lệ tắc mạch tương đối cao trên những trường hợp hẹp mạch ở HTHS (38,2%
p=0.409). Tỉ lệ hẹp lệch tâm là nhiều nhất (79/140
56,4%), theo sau là tắc mạch (39/140, 27,8%), hẹp đồng tâm (22/140
15,8%) (p=0.135). Trong các yếu tố nguy cơ, THA làm tăng tỉ lệ hẹp mạch 2,840 lần (p = 0,031, CI 95% [1,099
7,340]) và tỉ lệ xơ vữa mạch tỉ lệ xơ vữa mạch lên 3,102 lần (p = 0,012 và CI 95% [1,254
7,675]). Nhóm xơ vữa là nguyên nhân chủ đạo gây hẹp, tắc mạch (0.52%)
không xác định rõ nguyên nhân có tỉ lệ cao thứ hai (19.3%), tiếp theo là nguyên nhân co thắt mạch (15%), MoyaMoya (5.7%). Tổn thương nhu mô não có tỉ lệ cao nhất ở trường hợp hẹp, tắc mạch do xơ vữa (74%, p <
0.05).Kết luận: Bệnh lý hẹp mạch não thường gặp ở hệ tuần hoàn trước, chủ yếu gặp ở ĐM cảnh trong và não giữa. Xơ vữa là nguyên nhân thường gặp của hẹp động mạch não ở cả hệ tuần hoàn trước và sau. Tăng huyết áp là yếu tố nguy cơ của hẹp động mạch não.Objective: This study aims to describe the characteristics of cerebral artery stenosis on MRI and the relationship with some risk factors and causes of cerebral artery stenosis.Method: Cross-sectional descriptive study from 104 patients with images of intracranial artery stenosis using 3T MRI, from June 2021 to June 2022 at Bach Mai hospital, Hanoi, Vietnam.Results: The average age is 64.71 ± 14.08, the age group ≥60 accounts for the highest proportion of 76%, the male/female ratio is ~ 2.58:1. 27 patients (26%) had from two or more narrowing arteries. Stenosis is common in the anterior circulation (66.4%), the ratio posterior/anterior circulation ~ 2:1. ICA and MCA are the most affected (33,6% & 29,3%, respectively), ACA is the least affected (3,6%). In anterior circulation, moderate stenosis accounts for the highest rate (33.6%
p=0.008), arterial occlusion is relatively high in cases of stenosis in the posterior circulation (38.2%
p= 0.409). Eccentric stenosis is the highest (79/140
56.4%),followed by occlusion (39/140, 27.8%), concentric stenosis (22/140
15.8%) (p =0.135). Among risk factors, arterial hypertension increases the rate of stenosis by 2,840 times (p = 0.031, 95% CI [1,099
7,340]) and the rate of atherosclerosis by 3,102 times (p = 0.012), 95% CI [1.254
7.675]). Atherosclerosis is the main cause of arterial stenosis and occlusion (0.52%)
followed by the undetermined cause (19.3%), vasospasm (15%), and MoyaMoya (5.7%). Brain parenchymal damage has the highest rate in stenosis and occlusion due to atherosclerosis (74%, p <
0.05).Conclusion: Cerebral vascular stenosis is common in the anterior circulation, mainly in the ICA and MCA. Atherosclerosis is a common cause of cerebral artery stenosis in both the anterior and posterior circulation. Arterial hypertension is a risk factor for cerebral artery stenosis.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR