Therelationship Of Intracranial Atherosclerotic Plaque Characteristics And Early Neurologic Deterioration In Patients With Cerebral Infarction:High-resolution MRI Study

Aims:Using black-blood technology high-resolution magnetic resonance(HRMRI)analysis the relationshipofintracranial artery atherosclerotic plaque characteristics and early neurologic deterioration(END)in patients with acute cerebral infarction,so as to provide the basis for prevention and clinical treatment in patientsoccurringEND.Methods:This was a retro-prospective study of 110 patients with acute stroke who were admitted to the department of neurology of the second affiliated hospital of Dalian Medical University ranging from September 2016 to August 2017.According to the occurance END in 72 h after admission,the patients were devided into ENDgroup(24 cases)and non-END group(86 cases).Collect and sort out clinical information,including age,sex,diabetes mellitus,systolic blood pressure on admission,diastolic blood pressure on admission,history of smoking、drinking、coronary heart disease and stroke,degree of initial stroke(NIHSS score).Record laboratory index within 72 h admitted to hospital including fasting glucose,glycosylated hemoglobin,total cholesterol,triglyceride,low density lipoprotein cholesterol,high-density lipoprotein cholesterol.All patients admitted into the group complete black-blood3.0T HRMRIexamination.The plaque morphological features of responsibility arteryincluding eccentric/centripetal plaque,length of plaque,plaque enhancement,intraplaque hemorrhage was analysized.Use t-test and Chi square analyze the difference of each factor between ENDgroupand non-END group.Then using Logistic Regression model to compare the significant factors between ENDgroupand non-END group thus to conclude the independent risk factors of END.Results:1.This study included 110 cases ofpatients with intracranial large arteries atherosclerosis cerebral infarction,61 males(55.5%)and 49 females(44.5%),the average age is 68.16 ±4.27 years old.24 cases(21.8%)occurred ENDwithin 72 h after admission,14 males(58.3%),10 females(41.7%),the average age is 75.26 ±5.17 years old.2.Single factor analysis results: age,diabetes mellitus,systolic blood pressure on admission,diastolic blood pressure on admission,the initial degree of stroke(NIHSS score),fasting glucose,glycosylated hemoglobin,plaque enhancement,intraplaque hemorrhage were statisticaliy significant between the two groups(P < 0.05).3.Multi-factor analysis results: Affter using Logistic Regression model to compare the significant factors between ENDgroupand non-END group,it indicates that age(OR=1.20,95%CI 1.05-2.15,P<0.05),the initial degree of stroke(NIHSS score)(OR=1.32,95%CI 1.10-1.52,P<0.05),glycosylated hemoglobin(OR=1.12,95%CI 1.08-1.31,P<0.05),plaque enhancement(OR=2.31,95%CI 1.65-3.46,P<0.05),intraplaque hemorrhage(OR=2.86,95%CI 1.87-4.30,P<0.05)were independent risk factors of END occurance.Conclusions:1.The incidence of END in patients withintracranial large arteries atherosclerosis cerebral infarction is 21.8%.Age,degree of initial stroke(NIHSS score),glycosylated hemoglobin,plaque enhancement,IPH are independent risk factors;2.Analyzing the characteristics of the atherosclerotic plaque is helpful to determine the stability of plaque.Plaque enhancement obviously and IPH can be used aspredictorsof END.