Analysis Of Plaque Characteristics And Related Risk Factors In Patients With Symptomatic Intracranial Artery Stenosis By High Resolution Magnetic Resonance Imaging

Aims: In this study,3.0T high-resolution magnetic resonance imaging(HRMRI)based on black blood sequence is used to analyze the characteristics of atherosclerotic plaque in patients with symptomatic intracranial atherosclerotic stenosis(ICAS)stenosis.And symptomatic ICAS stenosis,risk factors are analyzed.At the same time,20 mg of atorvastatin calcium is given to patients with ICAS stenosis for 6 months.The HRMRI analysis of 20 mg of atorvastatin calcium is used to treat the wall changes before and after 6 months,to provide a basis for more scientific and rational prevention and clinical treatment.Methods: This study collects 179 patients diagnosed with ICAS stenosis who met the study criteria during the hospitalization of the Second Affiliated Hospital of Dalian Medical University from September 2016 to June 2018.Patients are divided into the symptoms of ICAS stenosis(100 cases)and non-symptomatic ICAS stenosis(79 cases)according to whether they have symptoms caused by ICAS stenosis at admission.Baseline data are collected for all enrolled patients,including gender,age,smoking history,history of diabetes,history of hypertension,systolic pressure at admission,diastolic pressure at admission and laboratory-related laboratory data within 24 hours of admission,including fasting blood glucose,total cholesterol,high density lipoprotein(HDL)cholesterol,low density lipoprotein(LDL)cholesterol,triglycerides.All patients enrolled in the brain are confirmed by magnetic resonance angiography(MRA)with intracranial artery stenosis(including middle cerebral artery stenosis and basilar artery stenosis),and completed HR MRI examination based on black blood technology.And analyze the morphological features of intracranialstenotic arterial plaques,including plaque length,intratracheal hemorrhage(IPH),and plaque enhancement.Multivariate logistic regression analysis is performed on statistically significant factors.All patients with ICAS stenosis are taking 20 mg atorvastatin calcium orally on a daily basis for 6 months.HRMRI is used to compare the changes of plaque characteristics before and after administration of atorvastatin calcium for 6 months.Using SPSS 24.0 version of the statistical software,the statistical data are expressed as mean ± standard,the comparison of measurement data is performed by t-test.The comparison of rate is performed by chi square test.P <0.05 is considered to have statistical Learning meaning.Results: 1.179 patients with ICAS stenosis,with an average age of 63.54±12.70 years old,including 107 males(59.78%)and 72 females(40.22%).Among them,symptom group has 100 patients(55.77%),with an average age of 63.32±11.23 years old,including 64 males(64.00%),36 females(36.00%),and asymptomatic group 79patients(44.13%),with an average age of 63.81 ± 14.41 years old,including 43 males(54.43%),36 females(45.57%).There was no difference in age and gender between the two groups;2.Symptomatic ICAS stenosis and non-symptomatic ICAS stenosis,there are statistically significant differences between the two groups in plaque enhancement,IPH,smoking history,fasting blood glucose,low-density lipoprotein(LDL)cholesterol,systolic blood pressure at admission,diastolic blood pressure at admission(P < 0.05).There are no statistically significant differences in age,gender,history of hypertension,history of diabetes,total cholesterol,high-density lipoprotein(HDL)cholesterol,triglycerides,and plaque length(P>0.05);3.Multivariate Logistic regression analysis of risk factors for symptomatic ICAS stenosis,it reveales that plaque enhancement(OR=0.79,95% CI 0.62-0.10,P=0.049),intra-plaque hemorrhage(OR=2.99,95% CI 1.04-8.61,P=0.042),smoking history(OR=2.52,95% CI 1.23-5.15,P=0.011),fasting blood glucose(OR=0.81,95% CI0.68-0.96,P=0.017)are independent risk factors for the onset of ICAS stenosis;4.Symptomatic ICAS stenosis group and non-symptomatic ICAS stenosis group both are taking 20 mg atorvastatin calcium orally on a daily basis for 6 months' sresults: About non-symptomatic ICAS stenosis group,there is a statistically significant difference in plaque enhancement(P<0.05),but there are no statistically significant differences in IPH and plaque length(P>0.05).About symptomatic ICAS stenosis group,there are statistically significant differences in plaque enhancement and IPH(P<0.05),but there is no statistically significant difference in plaque length(P>0.05).Conclusions:1.The independent risk factors for patients with symptomatic ICAS stenosis are plaque enhancement,IPH,smoking history,and increased fasting blood glucose;2.IPH and plaque enhancement are independent risk factors for symptomatic ICAS stenosis,which may be predictors of vascular wall in patients with clinical ischemic events with ICAS stenosis;3.Taking 20 mg atorvastatin calcium orally on a daily basis,for patients with ICAS stenosis,plaque enhancement is significantly reduced.For patients with symptomatic ICAS stenosis,there is also a significant reduction in IPH.