| BackgroundTransient ischemic attack(TIA)is the most obvious precursor of the complete cerebral apoplexy,therefore it is very important that the early prevention and treatment of transient ischemic attack's occurrence and development.The study found that intracranial atherosclerotic stenosis is the important reason that caused transient ischemic attack.Traditional examination methods can not show the vessel wall's structure and the plaque's properties effectively,because it is limited to vessel stenotic degree and hemodynamic level.High-resolution magnetic resonance imaging(HRMRI)technique is widely used in clinic practice because it can accurately determine whether there is atherosclerotic plaque and show the atherosclerotic plaques' shape,structural features and the relationship with the location of the perforator artery's incision clearly,further calculate the degree of luminal stenosis and the vessel wall remodeling index,also because its noninvasive,high repeatability and high accuracy and so on characteristics.ObjectiveTo investigate the characteristics of distribution about the transient ischemic attack patients' intracranial atherosclerotic stenosis of anterior circulation artery by HRMRI,therefore evaluate the correlation between the degree of luminal stenosis,the vessel wall remodeling nature and the occurrence of the anterior circulation TIA.MethodIn this study,we use the prospective study method,according to the incorporating andthe exclusion criteria,collected continuously 114 patients which were in accordance with anterior circulation TIA symptoms and lived in the Department of Neurology,Nanyang Central Hospital from June,2015 to June,2016.MRA was performed within 2 weeks of admission to see the number of cases of intracranial arterial atherosclerotic stenosis and the occurrence of stenosis.In order to find the artery with the highest incidence rate of atherosclerotic stenosis,the patients with stenosis of the artery were examined by HRMRI to find out the degree of stenosis and the remodeling of the wall.According to within 24 hours of the onset of TIA times as grouping criteria,more than 2 times as frequently prescribed group,<2 times for non frequent group.Vascular stenosis=(1-stenosis lumen area/ adjacent reference lumen area)×100%.Vascular remodeling rate= stenosis vascular area/ reference vascular area,when the vascular remodeling rate is greater than 1.05 is defined as the positive remodeling model,less than 0.95 is defined as the negative remodeling model,between 0.95 and 1.05 defined as the neutral remodeling model,the negative remodeling model and the neutral remodeling model are both defined as non-positive remodeling model.All data were analyzed using SPSS 19.0 software and the measurement data were expressed as average± standard deviation(x ±s).The measurement data is expressed in frequency or percentage,two groups were compared in independent sample t or test,it had statistically significant when it was different in P <0.05.Result1.This study found that 98(85.96%)patients had different degree of intracranial arterial stenosis of anterior circulation,16 cases(14.04%)had no stenosis of intracranial anterior circulation vessels,among 116 eligible patients.Of the 98 patients with atherosclerotic stenosis,153 lesions vessels were examined,including 28 cases(18.30%)of the internal carotid arteries,93 cases(60.78%)of the cerebral artery,32 cases(20.92%)of the anterior cerebral artery.2.Among the HRMRI examination of 93 patients who have atherosclerotic stenosisof the brain,we found that that there were plaques in the four parts of the upper and lower arteries of the stenosis artery,17 cases(18.28%)on the upper side,27 cases(29.03%)on the lower side,37 cases(39.79%)on the ventral sideand 12 cases(12.90%)on the dorsal side.3.According to the number of anterior circulation TIA attack in 24 hours,there were42 cases of non-frequency group,51 cases of frequent group,non-frequency group's most narrow lumen area was3.74±0.23 mm2,the frequent group's was3.68±0.20 mm2,P> 0.05,the difference was not statistically significant;non-frequency group's reference in lumen areawas 8.81 ± 0.16 mm2,the frequent group's was8.85 ± 0.15 mm2,P> 0.05,the difference was not statistically significant;the degree of vascular stenosis of non-frequent group was57.52±2.89%,the frequent group's was58.37±2.34%,both of them were moderate stenosis,P> 0.05,the difference was not statistically significant.4.Among 42 patients of non-frequent group and 51 patients of frequent group,non-frequency group's most narrow lumen area was 9.71 ± 0.35mm2,the frequent group's was 12.40 ± 0.32mm2,P<0.001,difference was statistically significant;non-frequency group's reference in lumen areawas 11.65 ± 0.53mm2,the frequent group's was11.28 ± 1.84mm2,P> 0.05,the difference was not statistically significant;vascular remodeling rate of non-frequent group was 0.84 ± 0.05,frequent group was 1.12 ± 0.14,P <0.001,difference was statistically significant.5.Among 42 patients in non-frequent group,there were 8 patients with positive remodeling(19.05%),34 patients with non-positive remodeling(80.95%,30 cases with negative remodeling,4 had neutral remodeling);during 51 patients in frequent group,there were 40 patients(78.43%)with positive remodeling and 11 patients with non-positive remodeling(21.57%,9 cases with negative remodeling and 2 cases with neutral remodeling);Frequent group's proportion of positive remodeling was significantly higher than that of non-frequent group,difference was statistically significant(P <0.001).Conclusion1.Vascular atherosclerotic stenosis occurred mainly in the middle cerebral arterybypass in patients with intracranial anterior circulation TIA;most are mainly distributed in the lumen of the ventral.2.The remodeling of the vascular wall is of great significance to the prediction of the clinical onset of ischemic cerebrovascular disease,and the stability of negative remodeling is higher than that of positive remodeling. |
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