Clinical And Imaging Study Of Intracranial Plaque Of Vertebrobasilar Artery

Objective: To observe the features of intracranial plaques of vertebral basilar artery using 3.0T High resolution magnetic resonance imaging(HRMRI).To analyze the risk factors affecting plaque stability and explore the correlation between plaque stability and new cerebral infarction,so as to realize the early clinical intervention and treatment of vertebral basilar artery ischemic events.Methods:1.We selected 59 patients with ischemic cerebrovascular disease who met the inclusion criteria in the Department of Neurology of Cangzhou Central Hospital between January 2019 to June 2020,and collected complete clinical data,such as age,gender,history of smoking and drinking,hypertension,diabetes,coronary heart disease(CHD),body mass index(BMI),low density lipoprotein cholesterol(LDL-C),triglycerides(TG),homocysteine(HCY),auxiliary examination results,etc.After HRMRI examination,according to whether the plaques evaluated by HRMRI were vulnerable,they were divided into the plaque stable group(n=38,64.4%)and the plaque unstable group(n=21,35.6%).Univariate and multivariate analyses were used to analyze the risk factors affecting the stability of vertebral basilar artery plaque.2.According to the presence or absence of new cerebral infarction,the enrolled patients were divided into new cerebral infarction group(n=27,45.8%)and non-new cerebral infarction group(n=32,54.2%),to analyze whether vulnerable plaques are more likely to lead to new cerebral infarction.3.SPSS 23.0 statistical software was used for statistical analysis.The measurement data conforming to normal distribution were expressed as mean± standard deviation,and the independent sample t test was used for comparison between groups.Median(interquartile interval)was used to represent the measurement data of non-normal distribution.Rank sum test was used for comparison between groups.Frequency,rate or percentage(%)were used to represent enumeration data,andχ~2 test was used for comparison between groups.Univariate and multivariate analyses were performed by Logistic regression analysis.P<0.05 indicated statistically significant difference,while P<0.01 indicated statistically significant difference.Results: 1.A total of 59 patients were included,and 0 patients were excluded due to poor image quality.Plaque stable group(n=38,64.4 %)and plaque unstable group(n=21,35.6 %);2.The patients with smoking and diabetes in the unstable plaque group were significantly higher than those in the stable plaque group,and the difference was statistically significant(smoking: chi-square value 7.881,P=0.005;Diabetes mellitus: chi-square value 9.126,P=0.003).There was no statistical difference in other baseline data between the groups;3.Multivariate logistic regression analysis was performed for the above cerebrovascular disease risk factors: smoking(P=0.011,OR(95%CI)=0.196(0.056-0.691))and diabetes(P=0.006,OR(95%CI)=0.172(0.049-0.606))were independent risk factors for unstable plaques;4.The plaque instability of newly cerebral infarction patients was significantly higher than that of non-newly cerebral infarction patients,and the difference was statistically significant(chi-square value was 5.740,P=0.017).Conclusions:1.HRMRI can qualitatively analyze intracranial atherosclerotic plaques and determine their stability,so as to realize the early prediction of new ischemic stroke in posterior circulation,and provide important predictive value for early intervention and treatment in clinical practice.2.The vulnerability of plaques in the intracranial segment of vertebrobasilar artery is significantly related to smoking and diabetes mellitus.Therefore,smoking cessation and strengthening blood glucose management are very important to prevent the occurrence of vertebrobasilar atherosclerosis.3.Plaque vulnerability is significantly associated with posterior circulation new cerebral infarction.Therefore,strict control of risk factors affecting the stability of vertebrobasilar atherosclerotic plaque is also of great significance for the prevention of posterior circulation new cerebral infarction.