| Objective: Carotid atherosclerosis is one of the main causes of ischemic cerebral vascular disease.The application of 3.0T magnetic resonance imaging provides a new model for the evaluation of carotid atherosclerotic plaque.The present study aimed to evaluate the carotid atherosclerotic plaque stability using 3.0T MRI in patient with ischemic cerebral vascular disease,and to analyze the factors affecting plaque stability.Methods: Patients with ischemic cerebral vascular disease were recruited from outpatient and ward of the Department of Neurology,Shanghai No.6 People's Hospital from June 2015 to February 2017.According to the inclusion criteria and exclusion criteria,86 patients met the criteria.All cases were examined by routine carotid Doppler ultrasonography and 3.0T MRI of carotid artery plaque,and according to the results of 3.0T MRI examination,the patients were divided into stable plaque group and unstable plaque group.Two groups of patients were recorded in the general situation,plaque location,degree of stenosis and routine blood test,blood coagulation,CRP,ESR,Hcy,anticardiolipin antibodies and other biochemical indicators.All data were analyzed using SPSS21.0(SPSS Inc,Chicago,IL,USA).The factors were compared between the two groups and Multivariate logistic regression analysis was used to analyze the factors affecting the stability of carotid plaque.P<0.05 was considered to indicate a statistically significant difference.Results: Of the 86 patients enrolled in the study,the stable plaque was found in 53 patients(61.63%)and unstable plaque group(n = 33,38.37%).The incidence of unstable plaque in patients with hypertension and diabetes was higher than that in non hypertension group and non-diabetic group,the difference was statistically significant(P < 0.05).There was a significant difference in the number of white blood cell count,fasting blood glucose,HDL,LDL and ESR between unstable plate group and stable plaque group(P < 0.05).Multivariate logistic regression analysis showed that diabetes mellitus(OR=1.14,95%CI 0.02~0.99,P=0.049),hypertension(OR=1.27,95%CI 0.04~1.95,P=0.045),LDL(OR=3.27,95%CI 0.97~11.07,P=0.047),ESR(OR=1.05,95%CI 0.99~1.12,P=0.041)were the independent risk factors for affecting carotid atherosclerotic plaque stability.The incidence of carotid artery stenosis and unstable plaque was also statistically significant(P < 0.05).There were 33(38.37%)cases of diabetes mellitus complicated with ischemic cerebral vascular disease,of which the stable plaque was found in 15(45.45%)patients and unstable plaque group(n = 18,54.55%),There was significant difference between the two groups in white blood cell count,fasting blood glucose,HbA1 c,HDL and Hcy(P < 0.05).Follow up of the patients,including 7 cases of recurrent ischemic cerebral vascular disease(2 cases of transient ischemic attack,5 cases of cerebral infarction),the stable plaque group 4cases(7.55%),unstable plaque group 3 cases(9.09%).Conclusion:3.0T MRI can effectively monitor the stability of carotid plaque stability;The stability of plaque is related to the degree of carotid stenosis,the greater the instability of plaque is higher;diabetes mellitus,hypertension,LDL and ESR are independent risk factors for plaque instability in patients with ischemic cerebral vascular disease;the stability of plaque and white blood cells count,fasting blood glucose,HbA1 c,HDL and Hcy;plaque recurrence probability of ischemic stroke than stable plaque.In patients with diabetes mellitus complicated with ischemic cerebral vascular disease,the stability of plaque was associated with white blood cell count,fasting blood glucose,HbA1 c,HDL and Hcy,and the probability of recurrent ischemic cerebral vascular disease was greater than that of stable plaque. |
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