Relationship Between Fetal-type Posterior Cerebral Artery And Intracranial Atherosclerotic Plaque On 3.0T High Resolution Magnetic Resonance Vessel Wall Imaging

Stroke has become one of the most important diseases endangering Chinese people’s health due to its high incidence,disability,and mortality.Ischemic stroke,the most common type of stroke,is mostly based on intracranial atherosclerosis.At present,many studies have proved that intracranial vascular morphology is related to intracranial atherosclerotic diseases.As the only non-invasive technique for vascular wall examination in body,vessel-wall magnetic resonance imaging(VW-MRI)has unique advantages in the evaluation of intracranial atherosclerotic vascular morphology,plaque distribution and vascular characteristics,which can predict the incidence of intracranial ischemic events and provide direct imaging basis for vascular interventional therapy and other clinical treatments.The first part of this study aims to study the relationship between intracranial atherosclerotic plaque distribution and acute cerebral infarction through VW-MRI;The second part is based on VW-MRI to explore the association between fetal-type posterior cerebral artery and intracranial atherosclerosis plaque.Part 1 Study on Intracranial Atherosclerotic Plaque Distribution and Its Relationship with Acute Cerebral Infarction Based on High Resolution Magnetic Resonance Vessel Wall ImagingPurpose: To investigate the relationship between intracranial atherosclerotic plaque distribution and acute cerebral infarction using VW-MRI.Methods: A total of 104 patients were included for 3.0T VW-MRI scan analysis.The patients were divided into acute cerebral infarction group and non-acute cerebral infarction group according to the limited diffusion of DWI sequences.The distribution of middle cerebral artery(MCA)and vertebrobasilar artery(VBA)plaque and its relationship with acute cerebral infarction were compared.Results: A total of 104 patients were enrolled,including 60 cases of MCA plaques,including 34 cases of abdominal and inferior wall plaque with 18 cases of acute cerebral infarction,and 26 cases of dorsal and superior wall plaque with 21 cases of acute cerebral infarction.There were more acute cerebral infarctions caused by dorsal and upper wall plaques than anterior and lower wall plaques,and the difference was statistically significant(P=0.025).There were 44 cases of VBA plaque,13 cases of abdominal plaque with 8 cases of acute cerebral infarction,12 cases of dorsal wall plaque with 7 cases of acute cerebral infarction,19 cases of bilateral wall plaque with 6 cases of acute cerebral infarction.There was no statistical difference in acute cerebral infarction caused by different plaque locations(P=0.172).Conclusion: MCA atherosclerotic plaques are more likely to occur in the abdominal and inferior wall of blood vessels,but dorsal and upper plaques are more likely to cause acute cerebral infarction.VBA plaques often occur on the bilateral wall of the vessel,but their distribution have no significant relationship with acute cerebral infarction.Part 2 Association between Fetal-type Posterior Cerebral Artery and Intracranial Atherosclerotic Plaque on 3.0T High Resolution Magnetic Resonance Vessel Wall ImagingPurpose: Intracranial vascular morphology is related to intracranial atherosclerotic disease,and the rupture of atherosclerotic high-risk plaque is one of the important factors leading to ischemic stroke.This study aims to use VW-MRI to quantitatively analyze the relationship between fetal-type posterior artery(FTP)and intracranial atherosclerotic plaques.Methods: A total of 110 patients were included for 3.0T VW-MRI scan analysis.Patients with atherosclerotic plaque were divided into FTP group(n=40)and non-FTP group(n=64).The images of the MCA and VBA vessel wall on VW-MRI were compared between the two groups based on the distribution,the degree of stenosis,remodeling index,and eccentricity index.Results: Plaques in the FTP group were more likely to be located in the dorsal and superior wall of the MCA.Positive remodeling of MCA plaque was more frequently observed in the FTP group than the non-FTP group(P<0.05).The remodeling Index was associated with FTP following the adjustment for the confounding factors(OR:30.125,95% CI: 1.262-719.079,P=0.035).No significant differences were found in the VBA plaque characteristics between the two groups(P>0.05).Conclusion: The plaques of FTP group are more prone to be located in the dorsal and superior wall in MCA.FTP promotes the development of atherosclerosis plaque and positive vessel remodeling in MCA,whereas it exhibits no association with VBA plaque distribution and formation.