Correlation Analysis Between Vascular Tortuosity And Thalamic Secondary Damage In Patients With Unilateral Middle Cerebral Artery Occlusive Cerebral Infarction

PurposeThis study calculated the tortuosity of bilateral posterior cerebral artery(PCA)and basilar artery(BA)in patients with unilateral middle cerebral artery occlusion(MCAO)and control patients.Then,analyzing the relationship between vascular tortuosity and secondary brain injury.MethodWe retrospectively enrolled patients with one side middle cerebral artery occlusion who estimated underwent Magnetic resonance at The First Affiliated Hospital of Guangxi Medical University between February 2015 and April 2021.Machine learning methods will be used to segment the thalamus,before calculating thalamic volume.Vascular tortuosity was measured by a 3D image analysis tool(Slicer 4.11.0).Statistical analysis was performed using SPSS version 22,the Mann–Whitney test the Study’s t-test was used to determine correlations.Besides,the correlation between various factors including the vascular tortuosity and secondary brain injury of the thalamus was investigated using logistic regression analysis.Results were considered statistically significant when P<0.05.Result1.Finally,a total of 65 patients with MCAO(19 females and 46 males)were included in our study and the age-and sex-matched control group consisted of 65 people(20 females and 45 males).The thalamus volume of the MCAO group was significantly smaller than that of the controls(5635±383 mm~3versus 5874±183 mm~3,P<0.0001).The vascular tortuosity of the PCA in the MCAO group was higher than the control group(82.8±17.3 versus 76.7±17.3,P=0.040).The vascular tortuosity of the BA did not differ between the MCAO group and controls(P=0.120).2.The logistic regression analysis results demonstrated that hypertension(P=0.021)and the PCA tortuosity(P=0.034)were independent risk factors of secondary brain injury of the thalamus.Moreover,adjusted for gender and age(P=0.020)and risk factors for cerebral infarction(P=0.048),the PCA tortuosity in the affected side still was an independent risk factor for secondary brain injury of the thalamus.3.Layered analysis:the volume of the affected side of the thalamus in the other groups with MACO was significantly smaller than that of the control group,except the 4–7-day group.4.The relationship between age and PCA tortuosity:In the occlusion group,the PCA tortuosity of patients is older than 60 years old was higher than that of patients is less than or equal to 60 years old(P=0.010),and was significantly higher than that of patients in the control group of the same age(P=0.024).The PCA tortuosity of patients in the MCAO group is less than or equal to 60 years old was higher than that of the control group(P=0.531).In the control group,the PCA tortuosity of patients is old than 60 years old was higher than that of patients is less than or equal to 60 years old(P=0.214),but there were not statistically significant.No significant difference in tortuosity of BA.5.The relationship between gender and PCA tortuosity:the tortuosity of the PCA in females with MACO was higher than males with MACO(P=0.001),and higher than females in controls(P=0.001).There is a statistically significant difference in BA tortuosity between males in the MCAO group and males in the control group.Conclusion1.Our present study demonstrates the vascular tortuosity of PCA is an independent risk factor for secondary brain injury of the thalamus after unilateral middle cerebral artery occlusive cerebral infarction.2.The reduction in the volume of the thalamus of the patient can be observed one week after unilateral middle cerebral artery occlusive infarction.3.After MCAO,the PCA tortuosity increased more significantly in patients aged>60 years and female patients.