本文選題：老年人　切入點(diǎn)：LEPAD　出處：《揚(yáng)州大學(xué)》2014年碩士論文

【摘要】：第一部分下肢血管HRMR管壁成像技術(shù)基礎(chǔ)與方法 本研究所用磁共振黑血血管管壁成像序列為3DMERGE,此序列血流抑制技術(shù)為iMSDE。股動(dòng)脈磁共振掃描時(shí)數(shù)據(jù)分兩段采集,在Philips后處理工作站將兩次掃描的圖像融合。圖像分析時(shí)將股動(dòng)脈分為三個(gè)節(jié)段：分叉段、收肌管段及遠(yuǎn)段。在MATLAB軟件中半自動(dòng)分析股動(dòng)脈。半自動(dòng)分析軟件具有較好可重復(fù)性,同一測試者兩次測量組內(nèi)相關(guān)系數(shù)為0.972、95%的可信區(qū)間為0.941-0.986,p值0.001。 第二部分HRMR管壁成像技術(shù)在老年人LEPAD中的應(yīng)用研究 目的：應(yīng)用高分辨率MRI管壁成像技術(shù)研究老年人LEPAD病變的影像學(xué)特征。 材料與方法：應(yīng)用MR管壁成像序列3D-MERGE對44位無下肢動(dòng)脈粥樣硬化相關(guān)臨床癥狀且年齡≥60歲受試者下肢動(dòng)脈成像。將下肢動(dòng)脈分為三個(gè)節(jié)段分析,分叉段、收肌管段及遠(yuǎn)段,分析斑塊發(fā)生率及鈣化發(fā)生率。應(yīng)用后處理軟件在2D橫軸位重建圖像上計(jì)算最大管壁厚度,斑塊負(fù)荷最大位置計(jì)算管腔狹窄程度及斑塊偏心指數(shù)。 結(jié)果：本組44例老年人下肢粥樣硬化斑塊發(fā)生率為63.6%,其中,50.0%的斑塊發(fā)生于分叉段,且該節(jié)段的斑塊負(fù)荷明顯大于其他血管節(jié)段。此外,最大管壁厚度與狹窄程度基本呈明顯正相關(guān)(r=0.769,p0.001)；0%狹窄的受試者中,11.1%出現(xiàn)斑塊。右側(cè)下肢斑塊負(fù)荷高于左側(cè),但差異無統(tǒng)計(jì)學(xué)意義。分叉段最大管壁厚度大于收肌管段及遠(yuǎn)段,差異有統(tǒng)計(jì)學(xué)意義(2.26±0.80mm vs.1.64±0.29mm, p0.001;2.26±0.80mm vs.1.88±0.69mm, p0.001)。 結(jié)論：高分辨率MRI管壁成像技術(shù)可以提供老年人群LEPAD病變的相關(guān)影像信息,可以評估斑塊負(fù)荷,為該疾病的診斷、治療和預(yù)防提供重要依據(jù)。 第三部分老年人LEPAD磁共振表現(xiàn)與臨床、實(shí)驗(yàn)室指標(biāo)的相關(guān)性研究 目的：應(yīng)用高分辨率MR管壁成像技術(shù)研究無癥狀老年人群下肢動(dòng)脈粥樣硬化病變特征與臨床、實(shí)驗(yàn)室指標(biāo)的相關(guān)性。 材料與方法：收集44例受試者臨床信息。應(yīng)用MR管壁成像序列3DMERGE對44位無下肢動(dòng)脈粥樣硬化相關(guān)臨床癥狀年齡大于或等于60歲受試者下肢動(dòng)脈成像。將下肢動(dòng)脈分為三個(gè)節(jié)段分析,分叉段、收肌管段及遠(yuǎn)段,分析斑塊發(fā)生率及鈣化發(fā)生率。應(yīng)用后處理軟件在2D橫軸位重建圖像上計(jì)算最大管壁厚度,斑塊負(fù)荷最大位置計(jì)算管腔狹窄程度及斑塊偏心指數(shù)。 結(jié)果：本研究發(fā)現(xiàn),性別與最大管壁厚度(p=0.002,r=0.464)、管腔狹窄程度(p=0.033,r=0.322)及偏心指數(shù)(p=0.006,r=0.407)有明顯相關(guān)性；身高與最大管壁厚度有明顯相關(guān)性(p=0.001,r=0.470)；體重與最大管壁厚度有明顯相關(guān)性(p=0.045,r=0.304)；高血壓與下肢動(dòng)脈有無斑塊有明顯相關(guān)性(OR=4.64, p=0.023);70-80歲年齡組下肢粥樣硬化斑塊發(fā)生率大于60-69歲年齡組(71.9%vs.41.7%,p=0.064)；ABI值與最大管壁厚度之間沒有明確相關(guān)性。 結(jié)論：高血壓與LEPAD關(guān)系密切,高血壓是評價(jià)老年人下肢動(dòng)脈粥樣硬化斑塊發(fā)生風(fēng)險(xiǎn)的有效指標(biāo)；隨著年齡增長,下肢粥樣硬化病變發(fā)生率增加；單純測量ABI會(huì)明顯低估LEPAD的嚴(yán)重程度。
[Abstract]:The basis and method of HRMR tube wall imaging in the first part of the lower extremities
This study used magnetic resonance imaging of blood vessels sequence is 3DMERGE. This sequence flow suppression technique for iMSDE. femoral artery magnetic resonance scanning data acquisition workstation is divided into two sections, will be the two time scanning image fusion processing in Philips image analysis. The femoral artery was divided into three segments: bifurcation, close myotubes and distal. In the software of MATLAB semi automated analysis femoral artery. Semi automatic analysis software has good repeatability, the same test two times measure intraclass correlation coefficient was 0.972,95% confidence interval was 0.941-0.986, P value 0.001.
The application of the second part HRMR tube wall imaging technique in the LEPAD of the elderly
Objective: To study the imaging features of LEPAD lesions in the elderly with high resolution MRI tube wall imaging.
Materials and methods: MR imaging sequences of 44 3D-MERGE without lower extremity atherosclerosis related symptoms and 60 years of age or older subjects of lower limb angiography. Lower limb artery was divided into three segments analysis, bifurcation section, adductor canal and distal analysis, plaque incidence and calcium application. Postprocessing software maximum wall thickness calculation in 2D axial image reconstruction, maximum plaque load calculation the degree of luminal stenosis and plaque eccentricity index.
Results: 44 cases of elderly patients with lower limb atherosclerosis incidence was 63.6%, among them, 50% of the plaque at the bifurcation segment, and the segment of plaque burden was significantly higher than that of other vascular segments. In addition, there was a significant positive correlation with the degree of stenosis of the maximum wall thickness of the basic (r=0.769, p0.001); 0% stenosis subjects, 11.1% plaques. The right side of the lower extremity atherosclerotic plaque burden is higher than that of the left, but the difference was not statistically significant. The maximum wall thickness is greater than the bifurcation of adductor canal and distal, the difference was statistically significant (2.26 + 0.80mm vs.1.64 + 0.29mm, p0.001 + 0.80mm + 0.69mm 2.26; vs.1.88, p0.001).
Conclusion: high resolution MRI tube wall imaging can provide related imaging information of LEPAD lesions in elderly people, which can evaluate plaque load and provide important evidence for the diagnosis, treatment and prevention of this disease.
The correlation of LEPAD MRI performance with clinical and laboratory indicators in the third part of the elderly
Objective: To study the correlation between the characteristics of the atherosclerotic lesions of the lower extremities and the clinical and laboratory indexes of the asymptomatic elderly people with high resolution MR tube wall imaging.
Materials and methods: the clinical data of 44 cases of subjects. The application of MR imaging sequence 3DMERGE of 44 lower extremity atherosclerosis related clinical symptoms of age greater than or equal to 60 year old subjects of lower extremity artery imaging. Lower limb artery was divided into three segments analysis, bifurcation section, adductor canal and distal analysis. The incidence rate of plaque and calcification. Application of postprocessing software maximum wall thickness calculation in 2D axial image reconstruction, maximum plaque load calculation the degree of luminal stenosis and plaque eccentricity index.
Results: the study found that gender and the maximum wall thickness (p=0.002, r=0.464), the degree of stenosis (p=0.033, r=0.322) and eccentricity index (p=0.006, r=0.407) have significant correlation; height is significantly correlated with the maximum wall thickness (p=0.001, r=0.470); body weight has significant correlation with the maximum wall thickness (p=0.045, r=0.304); hypertension and arterial plaques have significant correlation (OR=4.64, p=0.023); 70-80 year old age group of lower extremity atherosclerotic plaque occurrence rate of more than 60-69 year old age group (71.9%vs.41.7%, p=0.064); there is no clear correlation between ABI value and the maximum thickness of the tube wall.
Conclusion: hypertension is closely related to LEPAD. Hypertension is an effective index to evaluate the risk of atherosclerotic plaques in the elderly. The incidence of atherosclerotic lesions of the lower extremities increases with age. Only measuring ABI can significantly underestimate the severity of LEPAD.

【學(xué)位授予單位】：揚(yáng)州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R543.5

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相關(guān)期刊論文 前1條

1 王潔,李小鷹,何耀,倪彬;北京市萬壽路地區(qū)老年人群周圍動(dòng)脈硬化閉塞病橫斷面調(diào)查[J];中華流行病學(xué)雜志;2004年03期

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本文編號：1705967