| Part1The diagnosis and clinical value of MRI-T2 FLAIR high signal vascular sign in cerebral infarction in acute middle cerebral artery blood supply areaObjective:To investigate the occurrence of HVS in T2-FLAIR in patients with acute cerebral infarction in the middle cerebral artery blood supply area,to explore the correlation between HVS and middle cerebral artery stenosis and cerebral infarction area,and to explore the clinical significance of HVS in patients with acute ischemic cerebral infarction.Methods:103 patients who were diagnosed with cerebral infarction in the acute middle cerebral artery supply area from September 2017 to September 2018 were collected.Among them,male 66 cases and female 37 cases,aged 32~90 years,mean age 65.44±12.48 years old,All patients completed the MRI T1-FLAIR,T2,T2-FLAIR,DWI and 3D-TOF-MRA sequence examinations within 3 days(72 hours)of the disease,and compared the stenosis of the middle cerebral artery in the HVS positive group and the HVS negative group.Degree,area of cerebral infarction.Results:1.The incidence of HVS: In 103 patients with cerebral infarction,HVS was found in the blood supply area of the middle cerebral artery,and the incidence rate was 50.5%(52/103).2.There is no stenosis,mild stenosis(stenosis rate <50%),moderate to severe stenosis(stenosis rate(50%~99%)),and occlusion group(stenosis rate 100%)in the cerebral infarction side.The incidence of HVS was 0.0%,46.4%,83.3%,and 88.9%,respectively,which increased with the increase of cerebral artery stenosis in the cerebral infarction side,and the difference was statistically significant(P<0.05).3.The incidence of HVS was 33.3%,75.0% and 81.3% in patients with lacunar infarction(maximum infarction area ?1.5 cm2),focal cerebral infarction(1.5cm2< maximum infarction area?5.0 cm2)and large cerebral infarction(maximum infarction area > 5.0 cm2),respectively.The difference was significant with the increase of infarction area(P < 0.05).Conclusions:1.HVS is a common sign of acute ischemic cerebral infarction caused by middle cerebral artery stenosis,and the higher the degree of middle cerebral artery stenosis,the higher the incidence of HVS.2.The appearance of HVS suggests that the area of acute ischemic cerebral infarction is larger,the condition is more serious,and it has important reference significance for clinical treatment and prognosis.Part2The correlation between carotid artery stenosis and plaque and acute ischemic cerebral infarction in CTAObjective:The application of head and neck CTA combined with MRI was used to investigate the correlation between the degree of carotid stenosis and the location,surface morphology and properties of carotid atherosclerotic plaque and ischemic cerebral infarction,and to provide reference for clinical prevention and treatment of ischemic cerebral infarction.Methods:Collecting 38 patients with acute cerebral infarction who were diagnosed with acute ischemic cerebral infarction from March 2013 to September 2018 in Huaqiao Hospital,who completed brain MRI and head and neck CTA examination within one week.Patients with intracranial vascular disease were excluded.According to the MRI-DWI image of the brain,the location of the ischemic infarction was located on the infarct side of the carotid artery on the same side as the cerebral infarction,and the non-infarct side on the side of the cerebral infarction.Distribution of non-infarcted carotid atherosclerotic plaques,surface morphology,plaque internal component density,and stenosis of the lumen.Results:1.The detection rate of carotid artery stenosis in the cerebral infarction(73.3%)was significantly higher than that in the non-infarcted carotid artery stenosis(41.9%),and the difference was statistically significant(P<0.05).2.The risk of severe stenosis or occlusion of the carotid artery in the infarcted side(42.2%)was significantly higher than that in the non-infarcted side(6.5%).The risk of severe stenosis or occlusion of the internal carotid artery in the infarcted side(40.0%)was higher than that of the common carotid artery(4.4%)and carotid bifurcation(22.2%),and the difference was statistically significant(P<0.05).3.The detection rates of cerebral infarction and non-infarcted carotid plaque were 77.8% and 48.4%,respectively,and the difference was statistically significant(P<0.05).4.There was no significant difference in the distribution of cerebral infarction and non-infarctal common carotid artery,carotid bifurcation and internal carotid artery plaque(P>0.05).5.There were significant differences in the proportion of regular plaques,irregular plaques and ulcerated plaques in the cerebral infarction and non-infarcted carotid arteries(P<0.05).6.The incidence of non-calcified plaques,mixed plaques and calcified plaques between the infarct side and non-infarct side was no significant difference(P >0.05).The incidence of various types of plaques in the cerebral infarction was different in different parts.The difference was statistically significant(P <0.05);the proportion of unstable carotid plaque in the cerebral infarction was significantly higher than that in the non-infarcted side,and the difference was statistically significant(P<0.05).7.The plaques in the mild stenosis group accounted for a high proportion of calcified plaques and non-calcified plaques.The proportion of mixed plaques and non-calcified plaques in the moderate and severe stenosis(Including occlusion)group was high,and the difference was statistically significant(P <0.05).Conclusions:1.Cervical artery CTA combined with VR,MPR,CPR and other post-processing techniques,can accurately assess the degree of carotid stenosis,correctly evaluate the surface morphology,nature,type of carotid plaque,can be used as a routine method for cervical artery examination.2.The formation of carotid atherosclerotic plaque and different degrees of stenosis in the arterial lumen are important risk factors for cerebral ischemic lesions. |
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