Preliminary Application Of High Resolution Magnetic Resonance Vessel Wall Imaging In Study Of Middle Cerebral Artery Atherosclerotic Plaque And Lenticulostriate Artery Disease

According to the latest epidemiological data,stroke remains the second leading cause of death and disability worldwide,with an exponential increase in prevalence in the under-50age group,mainly manifested by ischemic stroke.The intracranial atherosclerosis disease(intracranial atherosclerotic diseases,ICAD)is one of the major causes of ischemic stroke.At present,a number of studies have proved that VW-MRI,compared with traditional imaging such as CTA DSA and TOF-MRA,can not only find more early hidden lesions of the vessel wall,but also qualitatively calculate the plaque burden and luminal stenosis degree.Therefore,the first part of this study aims to explore whether VW-MRI combined with 3D-FOT-MRA can detect more early and latent intracranial atherosclerotic lesions than single VWI or3D-TOF-MRA.The second part analyzed the relationship between the burden of atherosclerotic plaques in the middle cerebral artery and the type of infarction by VW-MRI.Thus provides the powerful imaging basis for the cerebral apoplexy patients infraction type and the clinical treatment.Objective:We hypothesized that vessel wall MR imaging(VW-MRI)with3D-time-of-flight magnetic resonance imaging(3D-TOF-MRA)together increases the ability to detect abnormal intracranial vessel segments compared to 3D-TOF-MRA or VW-MRIalone.To explore whether VW-MRI with 3D-TOF-MRA together can be used as a powerful tool for evaluating the abnormal intracranial vessel segments.Methods:Thirty-three subjects with a clinical history of suspected vasculopathy disease and have imaged with both VW-MRI and 3D-TOF-MRAs in two weeks who were hospitalized in the Zhongda hospital affiliated to Southeast University.Detecting the intracalvarium of internal carotid arteries,M1 segment of the MCA and basilar arteries.Two independent neuroradiologists classified vascular lesions into grades 1-4 based on VW-MRI and3D-TOF-MRA images.To compare the differences in detection of intracranial artery lesions in combination with 3D-TOF-MRA and VW-MRI together compared with 3D-TOF-MRA or VW-MRA alone.Significance was assessed by x~2 test.Results:A total of 33 patients were included in the study between VW-MRI and3D-TOF-MRA,165 arteries were studied.By comparing the detection rate of each segment of vascular lesions identified by TOF-MRA with VW-MRI combined with TOF-MRA lone.The difference in the detection rate of the intracranial segment 1 and 3 of the internal carotid artery and the M1 segment 1,2 and 3 of the middle cerebral artery and the basilar artery 1 and2 was statistically significant(P<0.05).Conclusion:3D-TOF-MRA and VW-MRI together identifies a higher number of abnormal vessel segments than 3D-TOF-MRA alone and may provide a more accurate assessment of disease burden.Objective: By using vessel-wall MR imaging(VW-MRI)to display the middle cerebral artery and the basal ganglia lenticulostriate arteries(LSAs),and to investigate the relationship between the middle cerebral artery plaque burden and the number and length of the lenticulostriate arteries in patients with different types of infarction in the basal ganglia.Methods: A total of 39 patients with unilateral basal ganglia acute cerebral infarction were retrospective included.According to the TOAST classification criteria,they were divided into large subcortical infarction(LSI)group or small lacunar infarction(SLI)group(18 cases),and another 19 patients with cerebrovascular disease symptoms but no acute cerebral stroke and MCA M1-2 without plaques were included as the control group.All patients underwent T1 WI VWI within 2 weeks.The length and number of the lenticulostriate arteries were calculated by 2 observers,and the plaque burden of MCA m1-2 segment was sketched.Intraclass correlation coefficient(ICC)was used to check the repeatability of measurement data between two observers.Kruskal-wallis test was used to compare the clinical data,LSA quantity and length among the three groups,and mann-whitney U test was used to compare the plaque burden between the LSI group and the SLI group.Multivariate logistic regression analysis was carried out to analyze the statistically significant indicators in the univariate analysis.Results: In the univariate analysis,there was no statistical difference in the clinical data of three groups.There were statistically significant differences in the length and number of lenticulostriate arteries among the three groups.The average length and number of LSAs in LSI group,SLI group and control group were 13.27±3.94 mm,2±0.77;15.76±4.89 mm,2.78±0.94 mm;16.34±5.89 mm,3.11±1.15,respectively.The length and number of LSAs in the LSI group were significantly shorter and less than those in the SLI(p =0.024,0.008,respectively)and the control group(p=0.027,0.001,respectively).However,the length and number of LSAs in the SLI group were not significantly different from that of the control group(p = 0.822,0.351,respectively).The plaque burden of the LSI group(94.9±42.3 mm3)was higher than that of the SLI group(51.5±24.6mm3)(p = 0.039).The multivariate logistic regression analysis showed that compare to the control group,the LSI group had shorter length and fewer number of LSAs,and the OR(95%CI)values were 0.646(95% confidence of interval 0.459-0.909)and 0.327(95% confidence of interval 0.130-0.822),respectively.The length and number of LSA in the SLI group were similar to that in the control group.Conclusion: The combined imaging of vascular wall and LSAs provides valuable help for the study of the pathogenesis and pathophysiological mechanism of deep perforation infarction.