The Correlation Between Imaging Features Of Unstable Plaque And Clinical Features Of Transient Ischemic Attack

Objective: we could understand the features of unstable plaque through High resolution magnetic resonance imaging(HRMRI),and the relationship between the feature of the unstable plaque and the frequency of transient neurological deficits in patients with transient ischemic attack(TIA)and the duration of each episode after transient ischemic attack was also known.Analysis whether the plaque causes the differences of the clinical features among the patients with TIA.Guiding the clinical treatment of patients with TIA.Methods:1Enrolled the person who were diagnosed as TIA,from January in 2015 to December in 2016,which all patients admitted to the Tangshan workers Hospital of Neurology.1.5T nuclear magnetic resonance,carotid ultrasound,Transcranial doppler(TCD)and other related examinations were performed on the patients after admission.General clinical data were collected.Selecting the TIA patients which with unstable plaques or arterial stenosis,and TIA symptoms were associated with carotid artery stenosis,Then HRMRI was performed,And the patients whose arterial stenosis were caused by unstable plaque were enrolled,Finally,134 patients were enrolled in the study.2All patients were given Aspirin 100 mg,Clopidogrel 75 mg,Atorvastatin Calcium Tablets 20 mg.And then HRMRI was given for further.To study the clinical characteristics of patients with transient ischemic attack in patients with unstable plaque.3All data were analyzed by SPSS17.0 statistical software.Patients were categorized according to the number of TIA episodes and the duration of each episode.Each characteristic of unstable plaque was analyzed by chi square test with single factor analysis in every group,when a P value <0.05 which was considered statistically difference in all analyses.Ordinal logistic regression was applied to statistic significant risk factors and analyzed the relationship between the characteristics of unstable plaque and the clinical features of patients with TIA.Then analyze,it is a protective factor for the severity of neurological deficits in patients with TIA when OR values <1.It is a risk factor when a OR values >1.Results:1There were 134 patients during this project.Statistical analysis of the134 patients is as follows: Group was divided according to the number of clinical neurological deficit and the duration of each group.Clinical neurological deficit episodes of no more than 1 times,2 or 3 times,more than3 times,and the number of patients were 55,42,37.They were divvied into three groups according to the duration of each episode,the number of patient whose duration time less than 10 min in group is 45,the number of patient whose duration time between 10 min and 30 min in group is 52,the number of patient whose duration time more than 30 min in group is 37.2The clinical data of each group which were enumeration data or measurement data were analyzed by rank sum test or single factor chi square test,and the P value was >0.05.The general clinical data of the patients had no effect on the number of seizures and the duration of each episode of TIA.3During the 7days in hospital,the number of the attack frequency which no more than 1 times was10,13,30,9cases,there were 9,22,23,11 patients,whose attack frequency between 2 and 3 times and the number was 20,17,19,15 whose attack frequency was more than 3 times.Group was divided according to the duration of each group.The number of each group was 45,52,37.There were 17,11,21,15 patients with a duration of no more than 10 minutes per episode,there were 20,24,20,27.10 patients whose onset symptom duration more than 10 minutes,but less than 30 minutes,the number of patients whose episode lasting time longer than 30 minutes was 23,27,20,17.4Using the collected clinical data to establish database and single factor analysis χ2 text was used respectively,to text continuous variables and categorical variables.Thin fiber cap,lipid core,intraplaque hemorrhage which the difference was statistically significant,(a=0.05,P<0.05).5Analyze the influencing factors on clinical characteristics of patients with TIA: we see that single factor such as thin fiber cap,lipid core,plaque hemorrhage which had statistically significant as independent variable(yes=1,no=0).See outbreak times and duration time of each episode as dependent variable(≤10min=1,10-30min=2,>30min=3)and(≤1times=1,2-3times=2,>3times=3).6The result is that lipid core,plaque hemorrhage,thin or fracture fiber cap into the regression equation,which the factors that influence the times and duration time of each episode.Lipid core,thin or fracture fiber cap and plaque hemorrhage are risk factors for clinical features in patients with TIA,causing the number of clinical seizures increased,and the duration time of each episode was prolonged.Plaque calcification had no association with the number of episodes and duration of each episode.Conclusion:1The high resolution magnetic resonance examination suggests that there is a high frequency and long duration of clinical seizures compared those patients whose unstable plaque had thin or fracture fiber,intraplaque hemorrhage,lipid core.2The calcified plaque has no significant effect on the frequency of clinical attack and the duration of attack though this study.