Analysis Of The Relationship Between Carotid Atherosclerotic Plaque And Acute Ischemic Stroke By High-Resolution Vascular Wall MRI

Objective:3.0T high-resolution MR vessel wall imaging was used to determine carotid plaque composition and burden,to investigate the relationship between plaque characteristics and acute ischemic stroke,and to evaluate stroke severity and determine plaque risk factors.Methods:The study included 60 patients with acute cerebral infarction in the blood supply area of the internal carotid artery.High-resolution Vessel Wall-Magnetic Resonance Imaging of carotid artery was performed with Siemens Skyra 3.0T magnetic resonance scanner,and MRI-Plaque View software was used to analyze the characteristics of plaque composition,measure and calculate Total Vessel Area(TVA),Lumen Area(LA),Wall Area(WA),Maximum Wall Thickness(MWT),Normalized Wall Index(NWI)and other plaque load indicators.According to the presence or absence of acute cerebral infarction in the blood supply area of the ipsilateral carotid artery,the bilateral carotid arteries of the patients were divided into the carotid artery group on the stroke side(64 cases)and the carotid artery group on the non-stroke side(56 cases).The stability,composition and load of carotid plaques were compared between the two groups using an independent sample t-test or X~ 2-test,and the relationship between the composition of different carotid plaques and the risk of acute ischemic stroke was analyzed by logistic regression.Patients were divided into two groups based on the National Institutes of Health Stroke Scale(NIHSS)score: NIHSS≤1 group(34cases)and NIHSS>1 group(26 cases).The clinical data and carotid plaque composition and load of the two groups were compared using X~2-test or t test.Based on Pearson correlation analysis of carotid plaque composition and load and NIHSS scores.Results:(1)Intraplaque hemorrhage(IPH),lipid-rich necrotic core(LRNC),and fibrous cap rupture(FCR)and calcification(CA)was significantly higher than that of the non-stroke side carotid artery.(2)Comparison of carotid plaque burden on the stroke side and non-stroke side:the differences of total vascular area(TVA),wall area(WA),normalized wall index(NWI),maximum wall thickness(MWT),and lumen stenosis rate between the groups was statistically significant(P<0.05),and the stroke side was significantly higher than the non-stroke side.(3)Logistic regression results of carotid plaque characteristics and ischemic stroke showed that IPH and FCR were strong exposure factors for ischemic stroke(OR values were 18.832 and 9.224,respectively,P<0.05),and LRNC and CA were also deficient factors.risk factors for hemorrhagic stroke,but the effect is weaker than the former two.(4)Compared with patients with NIHSS ≤ 1,patients with NIHSS>1 had significantly larger WA,NWI,MWT,and higher prevalence of IPH and FCR,the difference was statistically significant(P<0.05).(5)Pearson correlation analysis showed that NWI,MWT,IPH and FCR were positively correlated with NIHSS score(P<0.05).Conclusion :(1)IPH,FCR,LRNC and CA in carotid plaque components are important indicators for predicting ischemic stroke.Increased levels of TVA,WA,NWI,MWT and luminal stenosis,that is,increased carotid plaque burden,suggest an increased risk of ischemic stroke.(2)NWI,IPH,and FCR based on high-resolution MR vessel wall imaging may be useful indicators for evaluating the severity of ischemic stroke in patients with carotid atherosclerosis,and NIHSS scores were positively correlated with MWT,NWI,IPH,and FCR.