The Study Of High Resolution Magnetic Resonance Imaging And"Yin And Yang Type Certificate" For Symptomatic Intracranial Arterial Atherosclerotic Stenosis

ObjectiveTo study the plaque characteristics of symptomatic intracranial atherosclerotic stenosis and the impact of endovascular treatment on narrow wall and plaque characteristics by3. OT HR-MRI. To evaluate the relationship of the Yin and Yang type certificate characteristics of acute ischemic stroke with imaging parameters.Methods1.To analysis retrospectively the general data and HR-MRI data the patients with symptomatic intracranial atherosclerotic stenosis from February2011to February2014. To analysis Descriptively the selected patients with gender、age、risk factors、narrow area、Clinical symptoms and plaques characteristics.2. To figure out the remodeling index(RI) according to the result of HR-MRI, and RI≥1.05was defined as positive remodeling (PR), and RI＜1.05as non-PR. To analysis the gender、age、risk factors、plaque characteristics between the two groups.3. To evaluate the change of artery wall and plaque characteristics before and after endovascular treatment with3. OT HR-MRI.4. To observe the Yin and Yang type certificate characteristics of acute ischemic stroke, and to evaluate the relationship of Yin and Yang type certificate with imaging parameter.Result1.A total of22cases were included,17cases were male and5cases were female,mean age59.27±8.795years old;7cases presented with TIA,15cases with acute infraction;12cases with BA narrow,10cases with MCA stenosis. And17cases combine with hypertension, with diabetes mellitus10cases, with hypercholesterolemia14cases, with smoking11cases, with the history of stroke6cases. HR-MRI show that eccentric plaques on narrow area of all the22cases.2cases can found calcification and lcase can found bleeding on T1WI,15cases can found fibrous cap on T2WI,7cases can be obviously inhibition on FX, after injection of contrast medium,16cases can visible reinforcement on CE-T1WI.2. Among the15cases of PR and7cases of non-PR were included. The compare of risk factors between the two groups that PR group include more diabetes patients,the difference has statistical significance (P=0.045); NO notable correlation was found between the two groups of age、gender、other risk factors、 narrow area、clinical symptoms.And the compare of plaques characteristics between the two groups show that PR groups include more lipid core and reinforcement.3. A total of7cases treated with endovascular interventional.1cases treated with Gateway balloon expansion, and6cases treated with balloon expansion+Wingspan stents. The HR-MRI prompt that plaque unstable after endovascular treatment who treated with balloon expansion. One of the cases who had treated with balloon expansion+Wingspan stents that HR-MRI prompted plaques possible deformation and displacement, plaque character still unstable.1case of postoperative HR-MRI show eccentric plaque still exist, but character stable.4cases of postoperative HR-MRI prompt plaque disappear, lumen unobstructed, and the sent with lumen had fusion. All cases were followed up more than six months, and all cases did not found the same artery ischemia and stroke events again.4. A total of16patients with Yin class certificate, and6patients with yang class certificate. NO notable correlation was found between the two groups of gender、age、risk factors、stenosis site、plaque characteristics.Conclusion1. HR-MRI can clearly show the structure of vessel wall and plaque., and evaluating the character of plaques by pressure fat imaging and enhanced scanning imaging, but needs to improved its accuracy.2. Compare with the non-PR that PR more common in patients of symptomatic intracranial atherosclerotic stenosis. Diabetes is likely to be a factor leading to PR, and more lipid core and reinforcement be found in PR group, may prompt that the plaques unstable of PR group.3. Pure balloon expansion will change the structure of intracranial arterial wall, and maybe the plaques become unstable. The endovascular treatment with stent may benefit for the stability of the vessel wall, because the effect of attached to the wall.3. OT HR-MRI can clearly show the structure of artery wall and plaques characteristics before and after endovascular treatment, so Can be used to evaluate the change of the structure of artery wall and plaques characteristics after endovascular treatment.4. Yin type took up the major proportion in patients of acute ischemic stroke. NO notable correlation was found between the two groups of gender、 age、risk factors、stenosis site、plaque characteristics. Prompt that yin and yang type certificate reflect all pathological factors of the patient, embodies the overall concept.