Middle Cerebral Artery Plaque Characteristics In Prediction Study For The Risk Of Cerebral Infarction Based On High-resolution Magnetic Resonance Imaging

Objective:To analyze the imaging features of vascular wall and lumen between patients with cerebral infarction and non-cerebral infarction atherosclerotic of the middle cerebral artery(MCA)by using high-resolution magnetic resonance imaging,and to explore the MCA plaque characteristics in predictive value for the risk of cerebral infarction.Materials and methods:187patients with MCA atherosclerotic underwent 3DT1-SPACE and conventional magnetic resonance imaging.All patients were divided into cerebral infarction(n=92)and non-cerebral infarction(n=95)groups according to the clinical and imaging features.92 patients with cerebral infarction were assigned into three groups: acute phase(n=12),subacute phase(n=47),and chronic phase(n=33)according to the time since the onset of infarction.Plaque characteristics,including morphology,location,distribution,T1WI signal intensity and degree of enhancement were analyzed on 3DT1-SPACE.The vessel area(VA),lumen area(LA),lumen diameter,wall area(WA),stenosis rate,remodeling index,and plaque burden(PB)were calculated.Differences between cerebral infarction and non-cerebral infarction patients were statistically analyzed,as well as patients with cerebral infarction at different stages.Multivariate logistic regression analysis was performed to compare variables between cerebral infarction and non-cerebral infarction patients.Results:(1)Patients with cerebral infarction had a significantly higher prevalence of irregular surface plaques(63.0% vs.14.7%),eccentric lesions(78.3% vs.51.6%)and positive remodeling(68.5% vs.44.2%)compared with those with non-cerebral infarction(P<0.05).(2)Plaques were more commonly located at the ventral,but the location showing statistically insignificant between the cerebral infarction and non-cerebral infarction(P=0.672).(3)The WA,PB and stenosis rate were greater in patients with cerebral infarction than those with non-cerebral infarction(P<0.001).However,we found statistically insignificant in maximal lumen narrowing vessel area,reference vessel area and reference lumen diameter between two groups(P>0.05).(4)The occurrence rate of high signal intensity in T1 WI was low(10/187,5.3%),but patients with cerebral infarction had a significantly higher prevalence compared with those with non-cerebral infarction(9.8% vs.1.1%,P=0.02).(5)The degree of enhancement in cerebral infarction patients was statistically higher than that in non-cerebral infarction patients(P<0.001).(6)Positive remodeling and irregular surface plaques were independent risk factors in prediction of cerebral infarction.(7)Plaque characteristics of patients with acute,subacute and chronic phase cerebral infarction were compared.The subacute group had a significantly higher prevalence of irregular surface plaques compared with those with chronic group(P=0.015,P<0.0167),whereas other plaque features including distribution,location and signal characteristic showing statistically insignificant between three groups(P>0.05).Conclusions:(1)Eccentric lesion,irregular surface plaques,PB,high signal intensity in T1 WI,degree of enhancement,positive remodeling and degree of stenosis were risk factors of cerebral infarction in patients with MCA atherosclerosis.(2)Positive remodeling and irregular surface plaques were independent risk factors in prediction of cerebral infarction in patients with MCA atherosclerosis.(3)The plaque characteristics of MCA atherosclerotic patients can provide important information for the prediction of the risk of cerebral infarction.