| Objective: In our study,all of the atherosclerosis patients were acute cerebral infarction.MRA was performed and indicated bilateral middle cerebral arteries were no obvious stenosis.HR-MRI(high resolution magnetic resonance imaging,HR-MRI)with 3.0T scanner was performed.Then,we analyze stenosis rate,plaque stability,plaque burden,plaque location,and vascular remodeling to compare both MCA M1 segment of each patient.To analyze the correlation between these factors with acute cerebral infarction in non-stenosed middle cerebral arteries.To explore the pathogenesis and the risk of acute cerebral infarction with no obvious stenosis of middle cerebral artery.Methods: A total of 282 patients with acute cerebral infarction who underwent HR-MRI in our hospital were retrospectively analyzed.According to criteria,a total of 52 patient were chosen.Then we analyze plaque location and number of plaque,determine the stability of the plaque,and measure the patch level and reference level of the lumen area(Luminal area,LA),tube Wall area(Wall area,WA),vascular area(Vessel area,VA),Plaque area,Plaque area,PA),Plaque load and remodeling index(remodeling index,RI).Stenosis rate,plaque burden,plaque stability,the characteristic of plaque distribution,and vascular remodeling were took statistics and analyzed both MCA M1 segment of each patient.The results 1.The comparison was make about both side MCA M1 segment of the patients with acute ischemic stroke.Plaque burden of stroke side is greater than the contralateral side.The difference was statistically significant [(14.06 ± 4.616)% versus(12.23 ± 4.386)%;t=2.069,p<0.05 ];Differences of the stenosis rate of vessel had no statistical significance [(8.98 ± 4.404)% versus(8.90 ± 5.395)%;t=-0.080,p>0.05 ].2.The fifty of plaques were found on the stroke side of MCA M1.plaques were located: 21 cases at the superior wall,12 cases at the inferior wall,10 cases at the ventral wall,7 cases at the dorsal side.The percentages are this:42.0%,24.0%,20.0%,14.0%.The forty-seven of plaques were found on the contralateral stroke side,plaques were located: 7 cases at the superior wall,17 cases at the inferior wall,14 cases at the ventral wall,9 cases at the dorsal side.The percentages are this:14.9%,36.2%,29.8%,19.1%.on the both side,plaques are generally more inclined to be distributed in the inferior wall and ventral wall.The superior wall plaque of the acute cerebral infarction side were more than that of the contralateral side.The difference was statistically significant(χ2=8.694,p<0.05).3.On the stroke side,the number of unstable plaque was 35 cases(70.0%)and the number of stable plaque was 15 cases(30.0%).The number of unstable plaque of stroke side is greater than the contralateral side,the difference was statistically significant(p< 0.05).On the contralateral side,the number of unstable plaque was 14 cases(29.8%)and the number of stable plaque was 33 cases(70.2%).The number of unstable plaque of stroke side is greater than the contralateral side,the difference was statistically significant(χ2=3.941,p<0.05).4.On the stroke side,MCA M1 segment had positive remodeling of 29 cases,negative remodeling of 13 cases,no obvious remodeling of 10 cases.The percentages are this: 55.8%,25.0%,19.2%.on the contralateral side,MCA M1 segment had positive remodeling of 16 cases,negative remodeling of 18 cases,no obvious remodeling of 18 cases.The percentages are this: 30.8%,34.6%,34.6%.On both sides the proportion of vascular remodeling is different(χ2=6.848,p<0.05).The positive remodeling of acute ischemic stroke side is greater than the contralateral side.Conclusion 1.HR-MRI could more accurately detect and evaluate early atherosclerosis before obvious intracranial vascular stenosis.2.The incidence of acute cerebral infarction is related to plaque load,plaque on the superior wall of vessels,and the positive remodeling of the MCA M1 segment without obvious stenosis. |
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