| Objectives 1 This study images the vessel wall of MCA(Middle cerebral artery) with3.0T HRMRI(High-resolution magnetic resonance imaging), observes the distribution characteristics of plaque in symptomatic middle cerebral artery stenosis, and discusses the application value of HRMRI in diagnosis and treatment of intracranial large-artery atherosclerosis diseases. 2 The correlation of plaques distributed in different quadrants and CISS(Chinese Ischemic Stroke Subtype). 3 Discussing the influence of different cerebral vascular disease dangerous factors(such as hypertension, diabetes and so on) on the distribution of MCA plaques, the relationship between common cerebral vascular disease dangerous factors and middle cerebral artery stenosis according to the control study with non-plaque group.Methods Prospective method was used 37 patients hospitalized in the second department of neurology department, Tangshan Gongren Hospital affiliated to Hebei United University from March, 2013 to January, 2015, who are proved as primary cerebral infarction with DWI(diffusion weighted imaging) are collected continuously, after these patients are hospitalized, they are examined with HRMRI respectively, the target blood vessel is locked with 3D-TOF MRA scanning at first, then three sequences of scanning of GR T1 WI, GR T2 WI and PDWI are held on narrow section of blood vessels. At the same time, the baseline information of laboratory index(including blood glucose, triglyceride,total cholesterol, high-density lipoprotein, low density lipoprotein and homocysteine) and previous history(smoking history and drinking history) and so on are collected. According to distribution of plaque in middle cerebral artery which is determined with the vessel wall information provided by HRMRI scanning images, patients are divided into superior wall group, inferior wall group, ventral group and dorsal group, the influences of different cerebral vascular disease dangerous factors on the distribution of plaque in atherosclerosis are discussed, and the differences in pathogenesis of ischemic cerebral vascular events caused by plaques distributed in different quadrants are compared.Results 1 Atherosclerosis plaques are detected in MCA of all patients in groups. 2 There are 37 patients in this experiment, 10 patients were excluded, finally included 27 cases.Superior wall plaque accounts for 25.93%(seven cases), dorsal plaque accounts for11.11%(three cases), inferior wall plaque accounts for 25.93%(seven cases), ventral plaque accounts for 37.4%(10 cases), and the plaques are mostly seen in arterial ventral. 3In four groups of patients, the perforating branch lesion rate of superior wall group is85.7%(six cases), the perforating branch lesion rate of dorsal group is 100%(three cases),the perforating branch lesion rate of inferior wall group is 14.3%(one case), the perforating branch lesion rate of ventral group is 0%(zero case), the difference is very outstanding(P<0.001). 4 In four groups of patients, there are seven males and zero female in superior wall group; five males and two female in inferior wall group; nine males and one female in ventral group; zero male and three females in dorsal group, the chi-square value is 13.528, the P value is 0.004, P<0.05, the difference is very outstanding. 5 In four groups of patients, the difference in cerebral vascular disease dangerous factors of hypertension, diabetes, high-blood lipids, obesity, smoking, hyperhomocysteinemia, family history and so on is not outstanding. 6 Univariate analysis. Sex factor, the chi-square value is 7.695, the P value is 0.006, P<0.05, the difference between plaque group and nonplaque group is statistically significant, and it shows that there are differences in formation of intracranial atherosclerosis plaque in different sexes. Smoking factor, the chi-square value is 9.369, the P value is 0.002, P<0.05, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is obviously related to smoking. Obesity factor, the chi-square value is 14.244, P < 0.001, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is obviously related to obesity. Blood pressure factor, the chi-square value is 14.244,P < 0.001, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is obviously related to hypertension. Blood lipid factor, the chi-square value is 3.881, the P value is 0.049, P <0.05, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is obviously related to high blood lipid. Blood glucose factor, the chi-square value is 9.871, the P value is 0.002, P <0.05, the difference between plaque group and nonplaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is related to high blood glucose. Blood glucose factor, the chi-square value is 9.871, the P value is 0.002, P<0.05, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is related to high blood glucose. Homocysteine factor, the chisquare value is 8.759, the P value is 0.003, P<0.05, the difference between plaque group and non-plaque group is statistically significant, and it shows that the formation of intracranial atherosclerosis plaque is obviously related to homocysteine.Conclusions 1 HRMRI can image vascular wall, and provide biological information of atherosclerosis plaque while judging stenosis degree of blood vesse l.2 MCA atherosclerosis plaque mostly occurs in ventral, which is on the opposite side of perforating branch vessel, and atherosclerosis plaque in dorsal part, which is the opening of perforating branch artery, is rarely seen. 3 The mechanisms of ischemic events caused by plaques distributed in different quadrants are different, superior and dorsal plaque is easier to block the opening of perforating branch artery, thus to cause ischemic events. 4 The distribution of atherosclerosis plaque in different sexes is different, the atherosclerosis plaques of male patients are mostly seen in ventral part, and atherosclerosis plaques of female are mostly seen in dorsal part, which is the opening of perforating branch artery. 5 The influence of hypertension, diabetes, high-blood lipids, obesity, smoking, hyperhomocysteinemia and family history on the distribution of plaques is not obvious. 6 Sex, smoking, obesity,hypertension, hyperlipidemia, diabetes and hyperhomocysteinemia is related to intracranial atherosclerosis plaques. |
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