关键词: 椎底动脉供血不足, 高分辨血管壁成像, 管壁重构

Abstract: Objective  To investigate the role of high-resolution MR magnetic resonance vessel wall imaging (HR-MR VWI) in evaluating the remodeling of vertebrobasilar dolichoectasia (VBD) and its predictive value for cerebral infarction. 
Methods  A total of 200 VBD patients were selected and underwent HR-MR VWI examination. The patients were divided into the occurrence group (n=44) and the non-occurrence group (n=156) according to occurrence of cerebral infarction within 6 months. The vessel wall remodeling, vessel wall characteristics, and plaque characteristics were compared between two groups. Pearson analysis was used to analyze the relationship between vessel wall remodeling index and the narrowest luminal stenosis rate and plaque load. The relevant influencing factors of cerebral infarction in VBD patients and the value of HR-MR VWI parameters in predicting the occurrence of cerebral infarction in VBD were analyzed. 
Results  There was a significant difference between the occurrence group and the non-occurrence group with respect to the vessel wall remodeling (P＜0.05). Vessel area and wall area at the narrowest slice, the narrowest luminal stenosis rate and plaque load were higher than those in the non-occurrence group, and the number of unstable plaque was more than that in the non-occurrence group (P＜0.05). The wall remodeling index was positively correlated with the narrowest luminal stenosis rate and plaque load (P＜0.05). Positive remodeling, vessel area and wall area at the narrowest slice,the narrowest luminal stenosis rate, unstable plaque, and plaque load were independently associated with cerebral infarction in patients with VBD (P＜0.05). The area under ther receiver operating characteristic(ROC) curve (AUC)of the combination of positive remodeling, vessel area and vessel wall area at the narrowest slice, the narrowest luminal stenosis rate, unstable plaque, and plaque load in predicting cerebral infarction was greater than that predicted by a single indicator detection. 
Conclusion  HR-MR VWI examination has high evaluation value for vessel wall remodeling of VBD, vessel wall characteristics and plaque. The combined detection of each index can be used in clinical prediction of complicated cerebral infarction, and provides a reference for clinical intervention plan.

Key words: vertebrobasilar insufficiency, high-resolution vessel wall imaging, vessel wall remodeling