中文摘要：

目的 利用高分辨率磁共振（MR）成像,探讨中重度粥样硬化性大脑中动脉的重构模式.方法 2012年5月-2013年10月东南大学附属中大医院37例有症状的大脑中动脉粥样硬化性狭窄患者行3.0T MR检查,予大脑中动脉黑血技术T1WI、PDWI、T2 WI及3D-SPACE扫描,计算管壁、管腔、斑块面积及重构指数,分析各序列斑块特点,比较正性重构及非正性重构组之间的差别.结果 34例图像用于分析,19例为正性重构,15例为非正性重构.正性重构组管壁面积及斑块面积较非正性重构组大[管壁面积管腔最窄处：（10.9±2.5）mm^2比（9.2±1.9）mm^2,P =0.039;斑块面积：（6.4±1.9）mm^2比（3.9±1.1）mm^2,P=0],且斑块表面不光整（63.2％与20.0％,P=0.017）及DWI高信号灶（94.7％比60.0％,P=0.028）在正性重构组更多见.结论 正性重构的大脑中动脉粥样硬化患者,有大的斑块负荷,易于发生斑块破裂及继发卒中的风险.

英文摘要：

Objective To investigate remodeling mode of moderate or severe atherosclerotic stenosis of the middle cerebral artery （MCA）using high resolution MRI.Methods Thirty-seven consecutive symptomatic patients with atherosclerotic MCA stenosis were imaged with a 3.0-T magnetic resonance scanner.The HR-MRI protocol included four different scans：T1-weighted black blood imaging,T2-weighted MR,proton density （PD）-weighted MR,and 3D-SPACE.The wall area （VA）,lumen area （LA） and plaque area （PA） were calculated.The characterization of the plaque on HR-MRI was analysed.And the difference between positive remodeling （PR） and non-postive remodeling （non-PR） was explored.Results Thirty-four patients imaging was appropriate for analyse.Positive remodeling was found in 19 lesions.Compared with the non-PR group,the PR group had greater WA [（10.9 ± 2.5） mm^2 and （9.2 ± 1.9） mm^2,P =0.039）] and greater PA[（6.4 ± 1.9） mm^2 and （3.9 ± 1.1） mm^2,P =0].High intensity on DWI and irregularity of plaque surface were more frequently observed in PR than non-PR.Conclusion In patients with MCA atherosclerosis,PR lesions contain larger plaques than non-PR lesions and are probably with high risk for plaque rupture and subsequent stroke.