| Objective:To analyze the quantitative results of carotid arterial wall burden and plaque composition on both stroke and non-stroke sides in patients with ischemic stroke by 3.0T magnetic resonance.To explore whether the level of NLR are affected by the formation of vulnerable carotid plaques,and to analyze the clinical risk factors of vulnerable plaque in carotid arteries.Method:?From October 2017 to March 2018,a total of 57 patients diagnosed with stroke in Yanbian hospital were involved in this study,and all the participants were examined by 3.0T high-resolution MRI for carotid plaques.114 valid images of carotid arteries were divided into a stroke side group(65 cases)and a non-stroke side group(49 cases)based on whether there was an acute infarction in the ipsilateral carotid artery supply area.then the images were post-treated by VPD software.Quantitative analysis were used to compare the differences of wall burden,plaque componentsbetween the two groups.Logistic analysis was used to investigate risk factors for ischemic stroke.The burden of vascular wall includes vessel wall volume(VWV),wall thickness(WT),normalizedwall index(NWI),and maximal stenosis of the lumen.The mean and maximum of WT and NWI were selected respectively.Plaque components includes calcification(CA),lipid rich necrotic core(LRNC),intraplaque hemorrhage(IPH)and fibrin cap rupture(FCR),which were recorded as the presence/absence and the volume of plaque.?54 cases included after 2 cases with upper respiratory tract infection and 1 case with renal tumour which may significantly affect the body's inflammatory state were excluded.According to the results of plaque quantitative analysis in the first part,all patients were divided into 3 groups by the modified AHA plaque classification criteria(IV-V and VI were vulnerable plaques):Bilateral vulnerable plaque group(9 cases),unilateral vulnerable group(27 cases)and non-vulnerable plaque group(18 cases).Clinical data of all patients were collected for comparation and analysis,including general clinical data(Age,gender,body mass index,current smoking history,hypertension,diabetes)?blood routine(white blood cell count,neutrophil count,lymphocyte count,platelet count,manual calculation of NLR)and blood biochemical indicators(total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol).The clinical risk factors of Carotid vulnerable plaques were analyzed by ordered multiclass logistic regression.Result:?Comparison of the burden on carotid arterial wall between stroke side and non-stroke side:The level of meanWT,maxWT,maxNWI and stenosis of the lumen in stroke group were larger than non-stroke group,and the difference was significant(P<0.05).There was no differences in meanNWI between two groups(P>0.05).?Comparison of Components of the Carotid Atherosclerotic Plaque Between Stroke Side and Non-Stroke Side:There was no significant difference in the incidence of CA between the plaques in the stroke group and the non-stroke side of the carotid artery(P>0.05),but the volume of the CA had statistical differences between the two groups(P<0.05).The incidence and volume of LRNC,IPH and FCR in carotid plaques in the stroke group were significantly higher than those in the non-stroke group(P<0.05).?Logistic regression analysis of carotid plaque composition with ischemic stroke:IPH(OR=6.402)and FCR(OR=3.998)in carotid plaques are strong risk factors for ischemic stroke.LRNC(OR=2.642)and Stenosis(OR=1.078)were also risk factors for ischemic stroke,but the level of risk was weaker than IPH and FCR.There is no obvious risk relationship between CA and ischemic stroke.?Comparison of general clinical data between patients with vulnerable plaque,unilateral vulnerable plaque,and non-vulnerable plaque:The level of age,body mass index(BMI)and prevalence of hypertension were different in each group(P<0.05).There was no difference in male proportion,prevalence of diabetes,and smoking among 3 groups(P>0.05).?Comparison of blood routine and blood biochemical results in patients with vulnerable plaque,unilateral vulnerable plaque,and non-vulnerable plaque:neutrophil absolute count(LYM)and NLR were different among the three groups(P<0.05).There was no differences in other laboratory examinations.?An ordered multivariate logistic regression analysis of clinical risk factors of vulnerable plaque in carotid arteries:NLR(OR=2.542,95%CI= 1.306-4.943,P=0.006),age(OR?1.115 95%CI=1.027-1.212,P=0.009)and hypertension(OR=3.435,95%CI=1.071-11.023,P=0.038)were independent risk factors of carotid plaque vulnerability.Conclusion:?The 3.0T MR carotid artery plaque high-resolution imaging technique can clearly and comprehensively display the carotid artery wall,plaque,and adjacent tissue structures,which can provide more imaging help in the evaluation of carotid artery.?Elevated levels of VWV,WT,maxNWI,and Stenosis,which correlate with increased carotid wall burden and ischemic stroke.Wall burden can be used as imaging index to assess the risk of ischemic stroke.? IPH,FCR,and LRNC in carotid plaques are risk factors for ischemic stroke.? Inflammation markers NLR levels are closely related to the formation of vulnerable plaques in carotid arteries.NLR can be used as a laboratory indicator in the diagnosis of vulnerable plaques in carotid arteries.?NLR,age,and hypertension are independent risk factors for vulnerable plaque in carotid arteries... |
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