Analysis Of Correlation Between Posterior Circulation Infarction And Basilar Artery Curvature

Objective:Posterior circulation infarction(PCI)is the main pathogenesis of atherosclerosis,perforation of small arterial lesions and embolization.With the development of nuclear magnetic resonance techniques was widely used in clinical,it found that posterior circulation vessels with different degree of variation,not just the mechanism of vascular risk factors to promoted PCI,but also the variation of posterior circulation was found in different groups of nuclear magnetic resonance imaging(MRI).Basilar artery(BA)curvature was the most common vascular morphological changes.This study was to investigate the relationship between PCI and BA curvature,to explore the mechanism of BA curvature caused PCI,and to analyze the risk factors associated with posterior circulation infarction,and to analyze the relationship between BA curvature and vertebral artery dominance(VAD).For the prevention and treatment of cerebrovascular disease to explore new methods.Methods:Retrospectively collected 314 cases of acute cerebral infarction patients with complete data as subjects between January 2015 and December 2016 in the department of neurology from the Frist hospital of Baoding.All patients underwent head MRI(magnetic resonance imaging)and MRA(magnetic resonance angiography)examination,detailed records of each patient's history and signs,and through blood tests,ECG and other tests to assess the risk factors,such as the patient's gender,age and common cerebrovascular disease risk factors(high blood pressure,diabetes,coronary heart disease,transient ischemic attack history,previous stroke history,hyperhomocysteinemia(HCY),smoking history,drinking history).According to the performance of skull nucleus diffusion weighted imaging(DWI),the patients were divided intoanterior circulation infarction(ACI)group and PCI group,recorded the shape and direction of BA curvature.The risk factors of cerebrovascular disease and the ratio of BA curvature were compared between the two groups.The positive factors of single factor comparison were analyzed by Logistic multivariate regression analysis.Screened the independent risk factors of posterior circulation infarction,and to analysis the relationship between PCI and BA curvature,patients with PCI were divided into BA curvature group and BA without curvature group according to BA curvature standard,calculate the proportion of patients with vertebral artery dominanve in the two groups of patients and compared the incidence of VAD.Chi-square test was used to the relationship between the direction of BA curvature and VAD.Results:1.Among the 314 cerebral infarction patients,there were 212(67.5%)anterior circulation infarction,127 male and 85 female cases,the average age was 60.34±11.27;and there were 102(32.5%)PCI,67 male and 35 female cases,the average age was 61.41±12.46.A total of 64(20%)patients with cerebral infarction were diagnosed as basilar artery curvature,34 cases(16.0%)were found in anterior circulation infarction group,30 cases(29.4%)were found in PCI group,there was significant difference between the two groups(P=0.006).2.Among the 64 basilar artery curvature patients,there were 28(43.8%)C-typed,16(25.0%)anti-C typed and 11(17.2%)S-typed,so the curved shape of the basilar artery to C-typed main.3.The risk factors of 11 posterior circulation infarcts were analyzed by univariate analysis,it found that there was no significant difference in the incidence of age,sex,smoking,alcohol consumption,hypertension,diabetes mellitus,coronary heart disease and hyperlipidemia(P>0.05).But the BA curvature,hyperhomocysteinemia,and TIA history were compared between the two groups,there was remarkable statistical significance(P<0.05).4.The PCI as dependent variable,BA curvature,hyperhomocysteinemia and TIA history as independent variables,which were analyzed bymultivariate Logistic regression analysis,it found that the basilar artery curvature(OR 2.74,95% CI 1.477 to 5.112;P=0.001),hyperhomocysteinemia(OR 5.08,95% CI 2.984 to 8.662;P<0.001),and TIA history(OR 2.96,95%CI 1.499 to 5.861;P=0.002)were independent risk factors for PCI.5.Among the 102 PCI patients,there were 30(29.4%)BA curvature(67.5%),25 patients with VAD,and there were 72(70.6%)BA without curvature,12 patients with VAD,there was a significant difference in the two goups.Among the 30 BA curvature patients,there were 11 left BA curvature and 14 right BA curvature.Among the 14 right BA curvature patients,12 patients were diagnosed as left VAD.Among the 11 left BA curvature patients,8 patients were diagnosed as right VAD,there was a remarkable statistical significance(P<0.05).Conclusion:1.BA curvature were closely related to the occurrence of PCI,and were an independent risk factors for PCI.2.Hyperhomocysteinemia and TIA history were independent risk factors for posterior circulation infarction,the mechanism of posterior circulation infarction may be related to it.3.The incidence of VAD were higher in BA curvature patients,Basilar artery curvature generally toward the contralateral side of the VAD,Common in type C curvature.The VAD were probably risk factors of BA curvature.