Clinical Evaluation Of Atherosclerotic Plaque With High Resolution MRI

Purpose:Using High Resolution MRI to evaluate carotid atherosclerotic plaque with ischemic stroke patients,to discuss its value to the diagnosis of carotid atherosclerosis plaque,and its guiding significance of secondary prevention strategy.Methods:A total 79 patients who with ischemic stroke in our hospital neurology department during the period of April 2016 to October 2016 were include in the study,they divided into group A and B.Group A with 37 patients received carotid artery High Resolution MRI combined carotid ultrasound examination,Group B 42 patients received carotid ultrasound examination,gathering the general clinical data of two groups of patients,carotid High Resolution MRI images and carotid ultrasound image,the image analysis and statistical test,compared two groups of patients with carotid artery stenosis,vulnerable plaque detection rate,two groups of patients with secondary prevention intervention at the same time,90 days,6 months follow-up of patients after carotid atherosclerosis plaque related to the incidence of acute ischemic stroke and TIA.Results:The risk factors,clinical baseline data comparison between the two group s have no statistical difference(P > 0.05),Patients of Group A who received carotid artery HRMRI detect carotid artery mild stenosis 15 cases(20.27%),moderate stenosis 7 cases(9.46%),severe stenosis 16 cases(21.62%),total st enosis rate of 51.35%,Patients of Group A who received carotid ultrasound examination detect carotid artery mild stenosis in 14(18.92%),moderate stenos is in 9(12.16%),severe stenosis 7 cases(9.46%),total stenosis rate(40.54%),Patients of Group B who received carotid ultrasound examination detected ca rotid mild stenosis 15 cases(17.86%),moderate stenosis 7 cases(8.33%),sev ere stenosis 8 cases(9.52%),total stenosis rate(35.71%),the results show tha t a significant difference in detection rate of carotid severe stenosis between Group A with High Resolution MRI and Group A,Group B with carotid ultr asound(21.62% VS 9.52%,P<0.05).In group A were treated by modified the AHA of carotid artery plaque classification by means of high resolution MRI evaluation results found bilateral carotid artery is vulnerable plaques(type IV,V,VI)32 cases and stable plaques(type I-II,III,VII,VIII)34 cases,vul nerable plaque detection rate is 48.48%;Group A with carotid ultrasound dete ct vulnerable plaques 24 cases,vulnerable plaque detection rate was 36.36%,Group B with carotid artery ultrasound detection of 22 cases of vulnerable pl aques,55 cases of stable plaques,vulnerable plaque detection rate was 28.57%,the difference in Group A,Group B is significant(48.48%VS28.57%,P=0.014);To secondary prevention intervention,according to patients of two group s with follow-up,among them 35 cases of group A and group B 38 cases,90 days,6 months of carotid atherosclerosis plaque related cerebral infarction,TIA in 5 cases and 14 cases respectively,and the incidence of stroke were 14.28% and 36.84% respectively,comparison of two sets of stroke incidence is significant difference(14.28%VS36.84%,P=0.028).Conclusion:Compared with carotid ultrasound,High Resolution MRI showed better value of diagnosis for evaluating the carotid stenosis and carotid vulnerable plaques in ischemic stroke patients;According to the vulnerable plaque detection rate to modify secondary prevention strategy for patients with carotid artery stenosis,it can better reduce the incidence of ischemic cerebrovascular.