Analysis Of Middle Cerebral Artery Atherosclerotic Diseases At3.0T High-resolution Magnetic Resonance Imaging And Its Risk Factors

Objective: Using non-invasive3.0T high-resolution magnetic resonance angiographyto check the symptomatic middle cerebral artery atherosclerotic stenosis and plaque, todetermine the degree of stenosis, plaque location, plaque morphology, signal and enhancedplaque degree of enhancement, and to explore the clinical value of high-resolutionmagnetic resonance imaging in the evaluation of middle cerebral artery atherosclerosisnarrow disease.Methods: Between December2010to December2011period,120patients ofischemic cerebrovascular disease from Neurology Inpatient Ward of Changhai Hospitalwere chosen. Among them,82cases were male and38female, age23-76years old, averageage54.The scanning process was operated on3.0T magnetic resonance scanner. useGd-DTPA was injected by high-pressure syringe to enhance scan.3D-TOF MRA imagesdetermineed the location of the middle cerebral artery M1narrow segment vessels. hefollowing sequences were scanned including vertical sagittal T2WI, STIR and T1WI andof T1WI+C. The evaluation include:Unilateral or bilateral stenosis, stenosis or occlusion,narrow position, the shape of the plaque, the plaques signal on T2WI signal change ofplaque on T1WI enhanced scan, record data, then to analyze the proportion of these data.Results: Among120patients, there were72cases of stenosis,18cases of occlusion,12cases of Moyamoya disease,8cases of thrombosis and vacuities cases,10normal cases.The percentages were59%,15%,10%,7%and9%in previous sequence. Among72casesof stenosis, there were66cases of M1stenosis,6cases of M2stenosis. The percentageswere92%and8%. Among all cases, the numbers of left, right and bilateral cases were28,28and16. The percentages were39%,39%and22%. Among86, there were74cases ofeccentric plaque and12cases of annular plaque. The percentages were86%and14%.74eccentric plaque location: on the wall8, the anterior wall4, the anterior wall19, front wall 18and lower wall12, after six inferior wall, posterior wall3and4,Percentages were11%,6%,26%,24%,16%,8%,4%和5%。86plaques on T2WI,23cases of middling signalin T2WI,39cases of slightly higher signal in T2WI,4cases of higher signal in T2WI,,20cases of mixed-signal in T2WI. The percentages were27%,45%,5%and23%. Enhancedscan of stenosis of64segments,12cases of no enhancement in T1WI+C,22cases of slightenhancement in T1WI+C,30cases of enhancement in T1WI+C. The percentages were19%,34%and47%.Conclusions:1. High-resolution MRI can analysis of atherosclerotic plaque location,morphology, and composition. Based on the results, we recommend the use of HR-of MRInon-invasive to evaluate intracranial atherosclerotic plaques2. Middle cerebral arteryatherosclerotic plaque exists mainly as the eccentric form, with the most commonoccurrance in the anterior wall of the vessel.3. The enhancement of vulnerable plaque issignificantly higher than the enhancement of stable plaque. Because of small sample size,however, further research is required Objective: To compare the use of3.0T HR-MRI and DSA of the diagnosis of themiddle cerebral artery M1segment stenosis and discuss the clinical value and limitation ofHR-MRI diagnosis of middle cerebral artery atherosclerotic stenosis.Methods: Between December2010to December2011period,67patients of ischemiccerebrovascular disease from Neurology Inpatient Ward of Changhai Hospital were chosen.Based on the4th all China cerebrovascular conference, the diagnosis of these patientsinclude TIA, brain infarction and posterior circulation deficiency.(These patientsreceived Both3.0T HR-MRI and DSA were undergone within1week.3.0T HR-MRIdiagnosis of middle cerebral artery stenosis with DSA conformation was analyzed. Thesensitivity, specificity, accuracy, negative predictive value,and positive predictive value of3.0T HR-MRI diagnosis of middle cerebral artery stenosis were calculated using DSA asthe golden standard. The clinical value of3.0T HR-MRI diagnosis of intracranial vascular stenosis was evaluated．Results: Among67patients,there were134MCA M1segments examined by3.0THR-MRI and DSA,124blood vessels showed the same condition, with the coincidencerate of92.5%.3.0T HR-MRI diagnosis was slightly higher in5vessels,with false positiverate for3.7%,the diagnosis was slightly decrease in5vessels,with false negative ate for3.7%．The sensitivity, specificity, accuracy,positive predictive value,negative predictivevalue in3.0T HR-MRI diagnosis of mild degree MCA stenosis were80%,99.2%,98.5%,80%,99.2In Moderate degree MCA stenosis,were95.7%,98.5%,91.4%,84.6%,98.5%；In3.0T HR-MRI diagnosis of severe degree MCA stenosis,it were84%,98.2%,91.4%,80.8%,95.7%；In3.0T HR-MRI diagnosis of MCA occlusion,were100%,100%,100%,100%,100%．For mild,moderate,severe degree stenosis,and occlusion of MCA ratesaccording to Youden index were79.2%,94.2%,82.2%,100%；Kappa values were0.792,0.788,0.895,1．Conclusions:3.0T HR-MRI evaluation of middle cerebral artery atheroscleroticstenosis has a high sensitivity, specificity and accuracy, with a good relevance with DSA.3.0T HR MRI can replace DSA to become a general choice for cerebrovascular stenosisscreening test． Objective: To collect clinical data and test data of the middle cerebral arteryatherosclerotic stenosis patients, to study the relevant risk factors of the middlecerebralartery stenosis, and to clarify the population in risk, which may guide the clinic todo imaging examination.Methods: Between December2010to December2011,67patients with ischemiccerebrovascular disease from Neurologic Surgery Department were chosen. There were45males and22females, with mean ages of57±7years old (from31-76). The history of thesepatient (including hypertension, DM, smoking, and alcohol addiction) was collected, andthe blood pressure, blood glucose, cholesterol were examined. The stenosis of middlecerebral artery was taken as dependent variables, and above results taken as independent variables. χ2test and Logistic regression analysis were conducted.Results:1. Univariate analysis results: Hypertensive factor, between the case groupand control group χ2=39.717, P=0.000, P<0.05, Significant difference between the casegroup and control group, intracranial atherosclerosis and hypertension have a significantcorrelation. Diabetes factor, between the case group and control group χ2=3.173, P=0.044, P<0.05, Significant difference between the case group and control group,intracranial atherosclerosis and diabetes have a significant correlation. High cholesterolfactor, between the case group and control group χ2=7.297, P=0.007, P<0.05, Significantdifference between the case group and control group, intracranial atherosclerosis and highcholesterol have a significant correlation. A/G ratio factor, between the case group andcontrol group χ2=21.255, P=0.000, P<0.05, Significant difference between the casegroup and control group, intracranial atherosclerosis and A/G ratio decreased have asignificant correlation.2. Multivariate analysis results: hypertension, blood glucose, bloodlipid, and the value of A/G are risk factors of middle cerebral artery stenosis. The OR valueof hypertension is51.034(95%CI:8.940,291.321), which indicate the patients with HPhave51.034folds risk of intra-cranial artery stenosis than ones without it. The OR value ofhyperlipidemia is50.284(95%CI:7.2,351.180), which indicate the patients withhyperlipidemia have50.284folds risk of intra-cranial artery stenosis than ones without it,and the abnormality of cholesterol is the independent risk factor of arteriosclerosis. TheOR value of A/G is22.302(95%CI:4.642,107.136), which suggested that the patientswith decrease of A/G have22.302folds risk than normal ones.Conclusions:1. Univariate analysis results: The significant correlations are shownamong hypertension, DM, hyperlipidemia, decrease of the A/G and arteriosclerosis ofintra-cranial artery.2. Multivariate analysis results: hypertension, bloodlipid, and thevalue of A/G are risk factors of middle cerebral artery stenosis.