Imageology And Correlated Clinical Investigation Of Carotid Atherosclerotic Plaque

Objective:To investigate the value of noninvasive imaging,including Color doppler ultrasonography,Computed tomography imaging and Magnetic resonance imaging,in detecting the qualitative analysis in human carotid atherosclerotic plaque,and to assess the relationship between cerebral infarction and the stability of the carotid atherosclerotic plaque.Methods:Forty-eight patients(male 32 and female 16 aged from 44 to 80) diagnosed with TIA,vertebrobasilar insufficiency,or stroke were undergone US,CT and MRI screening,carotid atherosclerotic plaques were found by US first.Then all plaques were assessed with distribution, size,shape and the extent of the stenosis by CT and MRI.Characteristic of the signal in the plaque and its stability were analyzed by MRI.Statistical analysis was performed to evaluate the associativity between the type of the plaque and stroke.Results:1.According to the typing method of Color doppler ultrasongraphy,plaques are divided into four types.130 plaques were found by ultrasonography in 48 patients,four types of the plaque showed significant difference in the incidence of stroke After Statistical analysis(P＜0.05).2.According to the plaque typing method of AHA,plaques are divided into five types.MRI had found 119 plaques in the 48 patients,there was statistically difference of cerebral infarction incidence between the five types of plaque(P＜0.05).3.Most carotid atherosclerotic plaque occurred in BIF.There is statistical significance in the location of different types of plaque(P＜0.05).4.In the T2 FS weighted image,there was statistical difference before and after the enhancement in 39 plaques(P＜0.05).5.Statistical difference has been found in the analysis between morphologic characteristics of the surface of the plaque and stroke(P＜0.05). Conclusion:1.Multi sequences MR imaging,including FSE-T1WI,FSE-T2WI,FSE-T2,DIR and 3D TOF, can exactly locate the plaque and typing capability.It also can make component analysis for the plaque.2.Lower echogenicitied plaque,also called soft plaque,and typeⅣ-Ⅴ,Ⅵwith rough surface are high risk ones.3.TSE-T2 FS weighted image was more sensitive than other sequences to detect CAS, contrast-enhanced T2 FS weighted image may increase the CNR in the plaque and adjacent tissues.4.Aggregately analysing the morphology and component character of the plaque by US,CT and MRI imaging may bring us considerable clinical value in the prevention and therapy of cerbral infarction.