| The incidence of ischemic stroke is increasing.Intracranial atherosclerotic disease is the most important cause of ischemic stroke.The formation of atherosclerotic plaques involves a series of pathophysiological processes.HRMR-VWI is an emerging imaging modality.HRMR-VWI makes it possible to identify vessel wall lesions,accurately identify plaques,and perform qualitative and quantitative analysis.The intracranial vessels are divided into anterior and posterior circulation depending on their source.Some studies have pointed out that there are differences in vascular risk factors between anterior circulation and posterior circulation ischemic stroke.The stability of the plaques also varies from location to location,Previous literature is mostly based on qualitative analysis of plaque imaging features of single lesion vessels,lacking comparative studies of anterior and posterior circulation plaque features and responsible and non-responsible plaque features,and quantitative studies are even rarer.ObjectiveTo explore the imaging characteristics of different intracranial atherosclerotic plaques and to compare the risk factors and related differences in laboratory findings of plaques responsible for the anterior and posterior circulation in ischemic stroke by High resolution magnetic resonance vessel wall imaging.MethodsPatients with ischemic stroke within four weeks of onset who attended Jingzhou Central Hospital between August 2020 and January 2023 were retrospectively collected and underwent 3D-TOF MRA,DWI,and 3.0T HRMR-VWI plain and enhanced examinations at our imaging department.In this study,121 patients were included,of whom 13 had responsible plaques in both anterior and posterior circulation,and the remaining 108 were divided into anterior circulation responsible plaque group and posterior circulation responsible plaque group according to the location of the responsible plaque.In this study,we investigate the differences of risk factors and related laboratory indicators between anterior circulation and posterior circulation responsible plaques.The 293 plaques were grouped according to two classifications of plaque location and whether they were responsible plaques,and compare the HRMR-VWI imaging characteristics of different intracranial atherosclerotic plaques.Results1.Among the 121 patients,87(71.9%)were male,and the mean age of ischemic stroke onset was(58.94±8.11),34(28.1%)were female,and the mean age of ischemic stroke onset was(59.35±7.86).There was no significant difference in the mean age of ischemic stroke onset between them.In this study,the mean age of onset of ischemic stroke was(59.05±8.01).2.The incidence of hypertension,diabetes,and hyperlipidemia was higher in the posterior circulation responsible plaque group than in the anterior circulation responsible plaque group(P < 0.05).The total cholesterol content and triglyceride content in the posterior circulation responsible plaque group were higher than those in the anterior circulation responsible plaque group,and the differences were statistically significant.3.The remodeling index and plaque area in the posterior circulation plaque group were larger than those in the anterior circulation plaque group(P < 0.05).Negative remodeling was more common in the wall remodeling of anterior circulation plaques.There was no statistical difference in the degree of plaque intensification,length of involved vessels,plaque load,maximum wall thickness between the two groups(P >0.05).4.The length of vascular involvement in the responsible plaque group was longer than that in the non-responsible plaque group,and the plaque load and plaque area were larger than those in the non-responsible plaque group(P < 0.05),and the plaque remodeling index in the non-responsible plaque group was larger than that in the responsible plaque group(P<0.05).The proportion of severe stenosis or occlusion was large in the responsible plaque group,and the proportion of moderate stenosis was large in the non-responsible plaque group.A Part of indicators above were included in Binary logistic regression analysis revealing that plaque load(0R:1.07,95% Cl:1.026～1.117,P = 0.002)was an independent influencing factor for responsible plaque.5.There is a poor agreement in the degree of stenosis of vessels measured by3D-TOF MRA and HR-VWI,but they have a strong positive correlation;there are differences in stenosis rate and lumen area at the narrowest point(P < 0.001),and they had a strong positive correlation.Conclusions1.Patients with atherosclerotic stenosis in the posterior circulation should have tighter control of blood pressure and blood glucose,and lower total cholesterol and triglyceride levels.There are differences in HRMR-VWI imaging characteristics between anterior and posterior circulation plaques in patients with ischemic stroke.2.There are differences in HRMR-VWI imaging characteristics between the responsible plaque and the non-responsible plaque.Compared with the non-responsible plaque,the responsible plaque is more unstable,and plaque burden is an independent influencing factor for the responsible plaque.3.HRMR-VWI and 3D-TOF MRA have poor consistency in evaluating the degree of vascular stenosis.There were significant differences between HRMR-VWI and3D-TOF MRA in the measurement of vascular stenosis rate and the heaviest lumen area.HRMR-VWI of the same plaque has a greater stenosis rate,heavier stenosis and smaller lumen area at the narrowest point than that measured by 3D-TOF MRA. |
PDF Full Text Request