| BackgroundPatients with transient ischemic attacks（TIA）are at high risk of having an acute cerebral infarction in the short term,and there is still a lack of effective methods to predict the risk of TIA.Intracranial atherosclerosis（ICAS）is the most important cause of TIA,and the commonly used clinical angiography can only show the stenosis of the lumen caused by ICAS.The advent of high-resolution（HR）-magnetic resonance imaging（MRI）has made it possible to directly visualize the arterial wall itself.In addition,the enhancement of atherosclerotic plaque by HR-MRI enhanced scanning can reflect the status of new blood vessels and inflammatory activities within the plaque,providing a new technical means for us to study the occurrence and development of TIA.ObjectiveTo investigate the predictive value of HR-MRI enhancement of atherosclerotic plaque in middle cerebral artery（MCA）for frequent anterior circulation TIA.MethodsA total of 118 patients with prescription TIA who were admitted to the Department of Neurology,Nanyang Central Hospital from December 2019 to March 2021 were selected as the study subjects.Baseline data were collected and patients were divided into two groups based on the frequency of TIA within 24 h:frequent（≥2 TIA,56 cases）and non-frequent（<2 TIA,62 cases）.The degree of vascular stenosis and characteristics of plaque enhancement（including grade and mode of enhancement）were recorded.The independent sample T test was used for inter-group comparison of measurement data conforming to normal distribution,χ~2test was used for inter-group comparison of counting data,and rank sum test was used for inter-group comparison of grade data.Variables with statistically significant difference analysis（P<0.05）were included in multivariate Logistic regression（regression method）to analyze the influencing factors of frequent TIA.SAS9.4 statistical analysis software was used to complete single-factor analysis and multi-factor analysis,and Medcalic 15 was used to draw ROC curves.A two-sided test was performed with the test levelα=0.05.Results1.There were no significant differences in age,sex,proportion of smoking and drinking history,and incidence of obesity,coronary atherosclerotic heart disease and hyperlipidemia between the two groups（P>0.05）.The incidence of hypertension and diabetes in frequent frequency group was higher than that in non-frequent frequency group,and the degree of vascular stenosis was higher than that in non-frequent frequency group,with statistical significance（P<0.05）.2.The enhancement level and the rate of eccentric enhancement in the frequent group were higher than those in the non-frequent group,and the differences were statistically significant（P<0.05）.3.Multivariate Logistic regression analysis was conducted with hypertension,diabetes mellitus,degree of vascular stenosis,degree of enhancement and enhancement mode as independent variables,and frequency of TIA in anterior circulation as dependent variable.The results showed that the level of enhancement[β=1.283,SE=0.551,Waldχ~2=5.429,P=0.020,OR=3.607,95%CI（1.226,10.612）],enhancement pattern[β=-1.382,SE=0.689,Waldχ~2=4.022,P=0.045,OR=0.251,95%CI（0.065,0.969）]were the influencing factors for the frequent occurrence of anterior circulation TIA.4.According to the results of multivariate Logistic regression analysis,a model was established to predict the frequent risk of prosecution TIA by plaque enhancement characteristics,with log（p/1-p）=-1.697+1.283X1-1.382X2,where p was the frequent risk of prosecution TIA,X1 was the enhancement level,and X2 was the enhancement mode.ROC curve analysis showed that the AUC of the model to predict the frequent occurrence of circulation TIA was 0.761[95%CI（0.649,0.852）],the optimal truncation value was 0.44,the sensitivity was 79.55%,and the specificity was 64.52%.ROC curve analysis showed that the AUC of the model to predict the frequent occurrence of circulation TIA was 0.761[95%CI（0.649,0.852）],the optimal truncation value was 0.44,the sensitivity was 79.55%,and the specificity was64.52%.ConclusionThe risk of frequent TIA in the anterior circulation can be assessed based on the enhancement characteristics of atherosclerotic plaque in the middle cerebral artery by HR-MRI enhanced scan. |
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