A Correlation Study Between Carotid Atherosclerotic Plaque Stability And Acute Ischemic Stroke Based On High-Resolution Magnetic Resonance Imaging

Objective To comprehensively evaluate carotid plaque stability and early identify high-risk populations,we analyze the relationship between carotid atherosclerotic plaque stability and acute ischemic stroke(AIS)and their influencing factors by carotid high-resolution magnetic resonance imaging(HR-MRI)to reduce the incidence and mortality of AIS.Methods A total of 84 patients undergoing carotid endarterectomy(CEA)from June 2020 to September 2021 were collected.All patients received(HR-MRI)of the carotid artery before the operation.The medical records of all enrolled patients were collected,including the general condition,the results of the biochemical examination,and the pathological manifestations of carotid plaque specimens.The plaque stability and vascular wall load were analyzed by post-processing software,including lumen stenosis rate,maximum wall thickness(max WT),mean wall thickness(mean WT),wall standardization index(NWI),and plaque stability,plaque enhancement,and so on.1.According to the MRI classification criteria of carotid plaque combined with pathological findings,the patients were divided into the vulnerable group and the stable group.We explored the influencing factors of carotid vulnerable plaque by univariate analysis and multivariate logistic regression analysis.2.According to the existence of AIS in the blood supply area of the internal carotid artery on MRI routine sequence,the patients were divided into the AIS group and the non-AIS group.To explore the influencing factors of AIS and the correlation between carotid vulnerable plaque and AIS,the differences in general conditions,biochemical examination results,plaque stability,and vascular wall load between these groups were compared.Results 1.Among the 84 patients in the group,11 cases were excluded due to the failure of CEA,and 3 cases were excluded because the carotid artery specimens were incomplete and could not be accurately evaluated.Ultimately,70 cases met the inclusion criteria.2.The vulnerable group included 33 patients and 37 in the stable group.The age,proportion of hypertension,triglyceride(TG),and low-density lipoprotein(LDL-C)in the vulnerable group were higher than those in the stable group,while high-density lipoprotein(HDL-C)in the vulnerable group was lower than the latter,and the difference was statistically significant(P<0.05).3.The results of multivariate logistic regression analysis showed that age(OR 1.063,95%CI 1.008-1.120,P=0.023),hypertension(OR 3.522,95%CI 0.971-12.769,P=0.045)and HDL-C(OR 0.263,95%CI 0.007-0.525,P=0.011)were independent risk factors for vulnerable plaques.4.There were 39 patients in the AIS group and 31 patients in the other.The age,body mass index(BMI),and the proportion of patients with hypertension in the former were higher than those in the non-AIS group.The HDL-C in the former was lower than that in the non-AIS group.5.Mean WT,max WT,max NWI,and the detection rate of vulnerable plaque and enhanced plaque in the AIS group were significantly higher than those in the non-AIS group,and the difference was statistically significant(P<0.05).There were overall differences among the four groups of data with different degrees of carotid artery stenosis(P < 0.001).6.The detection rate of vulnerable plaque and enhanced plaque in the AIS group were significantly higher than those in the non-AIS group,and the difference was statistically significant(P<0.05).Conclusion 1.The interpretation of carotid atherosclerotic plaque by HR-MRI is in good agreement with the pathological results,and can accurately identify vulnerable plaques,which is of great significance for risk stratification and early intervention of key populations.2.Carotid plaque load and plaque stability are closely related to the occurrence of AIS,which can be used as one of the imaging indexes to evaluate ischemic stroke.