HR-MRI Imaging Study Of Posterior Circulation Cerebral Infarction With Vertebrobasilar Dolichoectasia

Objective(s):To explore the application of 3.0T high-resolution magnetic resonance(HR-MRI)in vertebrobasilar dolichoectasia(VBD)with posterior circulation cerebral infarction,and further understand the imaging characteristics of vertebrobasilar artery vascular wall and the risk factors for VBD with posterior circulation cerebral infarction.Methods:Patients diagnosed with VBD from January 2022 to January 2023 were be collected from the outpatient and inpatient treatment of the Department of Cerebrovascular Disease of the Sixth Affiliated Hospital of Kunming Medical University(Yuxi People’s Hospital).According to the diffusion weighted imaging(DWI)sequence examination,it was divided into VBD alone group and VBD with posterior circulation cerebral infarction group,and according to TOAST classification,xenophobic cardioembolic patients.All patients had high-resolution vessel wall imaging(HR-VWI)in HR-MRI completed within 1 week.The general data,biochemical indexes and HR-MRI imaging characteristics between the two groups were compared,and the correlation between the significantly different parameters and VBD and posterior circulation cerebral infarction was further analyzed,and the independent risk factors of VBD and posterior circulation cerebral infarction were obtained by dicategorical logistic regression analysis,and finally the predictive value of risk factors was analyzed by ROC curve.Results:A total of 61 cases of VBD were collected,including 30 cases in the posterior circulation cerebral infarction group and 31 cases in the VBD alone group.By observing the characteristics of vertebro-basilar artery HR-MRI vascular wall imaging in all cases,23 cases of atherosclerotic plaque were found,including 16 cases in the posterior circulation cerebral infarction group and 7 cases in the VBD alone group.Two cases of vertebrobasilar artery dissection were found,both in the posterior circulation cerebral infarction group;There were no vasculitis and intramural thrombosis and other vascular wall characteristics,and the remaining 36 cases had no lesions in the vertebrobasilar artery vascular wall.Further analysis of the characteristics of atherosclerotic plaques in the two groups of basilar artery(BA)and vertebral artery(VA)found that unstable plaques of basilar artery were associated with VBD and posterior circulation cerebral infarction.Using Spearman correlation analysis,sex,age,hypertension,lipoprotein(a)level,glycated hemoglobin ratio,creatinine value,basilar artery instable plaque were positively correlated with VBD and posterior circulation cerebral infarction.Dichotomous logistic regression analysis of the items with differences showed that age,lipoprotein(a)level,and basilar artery unstable plaque were independent risk factors for VBD and posterior circulation cerebral infarction,and the area under curve was 0.713(95% CI: 0.579-0.847),0.775(95% CI: 0.653-0.897),0.617(95% CI: 0.475-0.760),the results showed that basilar artery unstable plaque had no significant predictive value for VBD with posterior circulation cerebral infarction,and the comparative analysis of lipoprotein(a)and age curve pairing found no significant difference in the predictive value of VBD with posterior circulation cerebral infarction.Conclusion(s):1.The application of HR-MRI to study the characteristics of vertebrae-basilar artery wall has obvious advantages over traditional CTA and MRI: it can not only observe the lumen situation,but also display the vascular wall,find luminal stenosis and wall lesions,and show the vascular area,lumenal area,plaque load,remodeling index and plaque strengthening at the lesion site.2.The results of this group showed that the vascular lesions of vertebro-basilar artery were mainly atherosclerosis,and no arteritis and intramural thrombosis were seen;3.The results of this group showed that age,lipoprotein(a),and basilar artery unstable plaque were positively correlated with VBD and posterior circulation cerebral infarction,which was an independent risk factor for VBD and posterior circulation cerebral infarction,and there was no significant difference between age and lipoprotein(a)in the predictive value of VBD and posterior circulation cerebral infarction.4.In this group of patients,2 patients with VBD and posterior circulation cerebral infarction were found to have vertebro-basilar artery dissection,and the relationship between VBD,posterior circulation cerebral infarction and vertebrobasilar artery dissection can be further studied in the future.