Correlation Analysis Of Lenticulostriate Artery And Pathogenesis Of Recent Subcortical Infarction

Background and objectiveStroke is a major public health problem worldwide.Recent subcortical infarction(RSI)is one of the types of stroke.Recent subcortical infarction in the lenticulostriate artery(LSA)territory with a non-stenotic middle cerebral artery is a heterogeneous entity.The corresponding pathological types are branch atheromatous disease(BAD)and lacunar infarction(LI)respectively.The differentiation of two kinds of mechanism in the RSI is very important to help clinical diagnosis and guiding treatment.Although neuroimaging made some new progress over the years,but does not differentiate between the two kinds of pathogenesis.High-resolution vessel wall imaging and High field strength MRI appear to differentiate between the pathogenesis of RSI and guide therapy offers a potential possibility.Herein,we present the results of our investigation to determine differences in clinical features,LSA,and CSVD neuroimaging markers according to two different etiological subtypes RSI,defined prospectively according to designated BAD and CSVD-related LI,based on the spatial relationship between MCA plaques and LSA origin on HR-VWI.Materials and methodsA total of 80 patients with acute lenticulostriate artery infarction without middle cerebral artery(MCA)stenosis on magnetic resonance angiography(MRA)in China-japan Friendship Hospital of Jilin University from January 2020 to September 2022 were enrolled.All patients completed routine head magnetic resonance imaging(MRI),MRA,SWI and HR-VWI examination.RSI was dichotomized as branch atheromatous disease(BAD;a culprit plaque located adjacent to the LSA origin)(n =41)and CSVD-related lacunar infarction(CSVD-related LI;without plaque or plaque located distal to the LSA origin)(n =39).Gender,age,hypertension,diabetes,hyperlipidemia,smoking is collected.The characteristics of the lesions were recorded on conventional MRI,including length and location of infarct area and total cerebral small vessel disease(CSVD)score respectively.Bilateral MCA-M1 segment presence of arterial plaques were recorded.Application SPSS25.0software for statistical analysis.Compare the difference between the two groups,and using Logistic regression analysis to determine independent risk factors for the two groups of subtypes.Results80 subjects were included,including 58 males and 22 females.41 cases had plaques in the MCA-M1 segment of the affected side,that is,BAD group,and 39 cases in non-plaque group,namely,LI group.The demographic characteristics,vascular risk factors,and laboratory examination results of the two groups have no statistical difference(P >0.05).The infarct diameter and number of lesion axial slices of the two groups have statistical difference(P < 0.05).The CSVD imaging markers of the two groups have statistical difference(P < 0.05).The number of LSA branches of the two groups have statistical difference(P < 0.05).The number of LSA stems and total length of the two groups have no statistical difference(P >0.05).Logistic regression analysis shows that the reduction in the number of LSA branches associated with BAD(OR,16.152;P values < 0.05).ConclusionsThe LSA branches may differentiate subtypes of RSI.The HR-VWI technique could be a credible tool to differentiate the heterogeneous entity of RSI in the LSA territory.