Objective:To evaluate the responsible vessels for ischemic stroke with computed tomography arteriography (CTA) and high resolution-magnetic resonance imaging (HR-MRI) , and to explore the relationship between the occurrence and development of cerebral infarction and the degree of vascular stenosis, the composition and stability of the responsible plaque. Methods: Patients who underwent routine brain MRI examination from August 2018 to December 2020 in our hospital and diagnosed with acute cerebral infarction of unilateral middle cerebral artery (MCA) territory were included in the study. CTA and HR-MRI were used to analyze the degree of lumen stenosis caused by MCA atheromatous plaque and possible plaque components, 20 cases in each group (CTA group and HR-MRI group) and the HR-MRI group included 10 patients with HR-MRI plain scan (HR-MRI plain scan group, n=10) and 10 patients with contrast-enhanced HR-MRI (HR-MRI contrast-enhanced group, n=10). The image post-processing workstation was used to outline the infarction and measure the maximum sectional area, and two experienced diagnosticians analyzed the stenosis degree, plaque composition, and plaque enhancement degree of the responsible vessels. Pearson's linear correlation and Spearman's rank correlation were used to evaluate the relationship between the degree of vascular stenosis and infarct size. Chi-square analysis was used to compare the infarct size of patients with different plaque components and different plaque enhancement degrees. Results: There was no correlation between the degree of responsible vessel stenosis and the infarct size in either the CTA group or the HR-MRI group (P＞0.05). In the HR-MRI plain scan group, the plaques showed high or slightly high signal of T1WI, and the infarct size of those with the mixed signal of T2WI was significantly higher than that of those with other signals (P＜0.05). In the HR-MRI contrast-enhanced group, the infarct area of the patients with high plaque enhancement was significantly larger than that of the patients with moderate enhancement (P＜0.05). Conclusion: Compared with the stenosis degree of the responsible vessel, intracranial arterial plaque hemorrhage and inflammatory response are more important prognostic factors for cerebral infarction.
JIN Tao
,
CHEN Qiang
,
LUO Lin
. Correlation between intracranial atherosclerotic plaque shape and infract size[J]. Journal of Baotou Medical College, 2024
, 40(7)
: 62
-67
.
DOI: 10.16833/j.cnki.jbmc.2024.07.011
[1] Zhang DF, Chen YC, Chen HY, et al. A high-resolution MRI study of relationship between remodeling patterns and ischemic stroke in patients with atherosclerotic middle cerebral artery stenosis[J]. Front Aging Neurosci, 2017, 9:140.
[2] 张权, 韩广明, 乔建勇, 等. 彩色多普勒超声、CTA、DSA诊断颈动脉狭窄的准确性对比分析[J]. 世界最新医学信息文摘, 2019, 19(16):1-2.
[3] 沈华. 头颈联合CT血管造影在头颈动脉狭窄中的应用[J]. 临床医药文献电子杂志, 2019, 6(1):153.
[4] Sadat U, Teng ZZ, Young VE, et al. Three-dimensional volumetric analysis of atherosclerotic plaques:a magnetic resonance imaging-based study of patients with moderate stenosis carotid artery disease[J]. Int J Cardiovasc Imaging, 2010, 26(8):897-904.
[5] 肖嘉昱, 蒋涛, 杨旗, 等. 短暂性脑缺血发作患者颅内动脉斑块特征的高分辨率磁共振研究[J]. 中国医学影像学杂志, 2019, 27(8):578-583.
[6] Yang WJ, Wong KS, Chen XY. Intracranial atherosclerosis:from microscopy to high-resolution magnetic resonance imaging[J]. J Stroke, 2017, 19(3):249-260.
[7] 刘聪, 宋焱. 磁共振血管壁成像对颅内动脉粥样硬化斑块易损性及疗效评估的研究进展[J]. 磁共振成像, 2022, 13(3):118-121.
[8] 王红茹, 高阳, 吴琼. 高分辨率磁共振血管壁成像在颅内动脉粥样硬化斑块上的研究进展[J]. 磁共振成像, 2021, 12(9):95-97, 102.
[9] 王洁, 陈峰, 董海波, 等. 功能磁共振对颈动脉狭窄患者支架植入术前后脑功能改变的评估作用[J]. 中国现代医生, 2018, 56(6):107-111.
[10] 韦程纲, 谭洁莹, 徐向东, 等. 磁共振高分辨扫描在基底动脉斑块中的应用[J]. 广东医学, 2018, 39(4):544-547.
[11] 肖晓怡, 曾献军. 高分辨磁共振成像在颅内动脉夹层的应用进展[J]. 江西医药, 2018, 53(2):179-182.
[12] Turan TN, Rumboldt Z, Granholm AC, et al. Intracranial atherosclerosis:correlation between in-vivo 3T high resolution MRI and pathology[J]. Atherosclerosis, 2014, 237(2):460-463.
[13] Portanova A, Hakakian N, Mikulis DJ, et al. Intracranial vasa vasorum:insights and implications for imaging[J]. Radiology, 2013, 267(3):667-679.
[14] Chen XY, Wong KS, Lam WWM, et al. Middle cerebral artery atherosclerosis:histological comparison between plaques associated with and not associated with infarct in a postmortem study[J]. Cerebrovasc Dis, 2008, 25(1-2):74-80.
[15] Mazighi M, Labreuche J, Gongora-Rivera F, et al. Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke[J]. Stroke, 2008, 39(4):1142-1147.
[16] Labadzhyan A, Csiba L, Narula N, et al. Histopathologic evaluation of basilar artery atherosclerosis[J]. J Neurol Sci, 2011, 307(1-2):97-99.
[17] Ibrahim T, Makowski MR, Jankauskas A, et al. Serial contrast-enhanced cardiac magnetic resonance imaging demonstrates regression of hyperenhancement within the coronary artery wall in patients after acute myocardial infarction[J]. JACC Cardiovasc Imaging, 2009, 2(5):580-588.
[18] Qiao Y, Zeiler SR, Mirbagheri S, et al. Intracranial plaque enhancement in patients with cerebrovascular events on high-spatial-resolution MR images[J]. Radiology, 2014, 271(2):534-542.
[19] Lau AY, Zhao YD, Chen C, et al. Dual antiplatelets reduce microembolic signals in patients with transient ischemic attack and minor stroke:subgroup analysis of CLAIR study[J]. Int J Stroke, 2014, 9(Suppl A100):127-132.
