Analysis Of The Cerebral Artery CTA Results And Correlation Of The Cerebral Artery Stenosis And Hypertension In Ischemic Stroke Patients

Part1Analysis of the cerebral artery CTA results in ischemic stroke patientsObjective: To provide more clinical information for the prevention and treatment ofischemic cerebrovascular disease, the location and extent of the intracranial andextracranial arterial plaque, stenosis (especially intracranial arteries) with CTA in patientswith ischemic stroke were analysed.Methods:244cases of ischemic stroke patients, confirmed in accordance with theinclusion criteria, hospitalized in the Second Affiliated Hospital of Soochow Universitywere enrolled. The cerebral artery were scaned by the dual-source64-slice CT, analysed bythe multi-planar reconstruction (MPR), curved planar reconstruction (CPR), maximumdensityprojection (MIP) and volume rendering (VR) reconstruction technology. The arterydiameter were measured by expanding the axial picture. The classification of vascularstenosis were evaluated according to the North American Symptomatic CarotidEndarterectomy Trial (NASCET) standards. The datas were analysised.Results: The results showed that the artery stenosis occurred in194patients, of which,175cases of patients with intracranial arterial stenosis,50cases with pure intracranialartery stenosis,125cases with intracranial and extracranial arteries.narrow,19cases withextracranial arteries, and50cases without cerebral artery stenosis. A total of3660bloodvessel were evaluated, of which,1115narrow blood vessels (30.72%) and911pieces ofplaques were found. Among the narrow blood vessels,141occurred in the extracranialblood vessels (12.7%),974(87.3%) occurred in the intracranial blood vessels,675(60.53%) occurred in the anterior circulation, and440(39.46%) occurred in the posteriorcirculation. Among the911pieces of plaques,170plaques (123non-calcified plaque,calcified plaque47) occurred in the extracranial segment and741(137non-calcifiedplaque,604calcified plaque) occurred in the intracranial segment. Among the plaques,most non-calcified plaques were found in the extracranial segment of internal carotid artery (P <0.001), most calcified plaque were found in intracranial segment of internal carotidartery (P <0.001).Conclusion: In chinese patients, intracranial arterial stenosis is the main reason forthe incidence and recurrence of ischemic stroke. Compared with the extracranial arteries,there were a higher rate of arterial stenosis and more artery calcified plaques in theintracranial artery. part2Correlation of the cerebral artery stenosis and hypertensionObjective: Study the relationship between cerebral artery stenosis and hypertensionand make a further analysis of correlation of cerebral artery stenosis and blood pressurelevel.Methods:244cases of ischemic stroke patients, confirmed in accordance with theinclusion criteria, hospitalized in the Second Affiliated Hospital of Soochow Universitywere enrolled. All patients were underwent a cerebral artery CTA within week, and theirblood pressure, blood lipids and other indicators were recorded. The patients were devidedinto two groups according to their CTA results, and then analyzed the correlation of thecerebral artery stenosis and hypertension, and compared the blood pressure, lipids andother indicators among the groups. The datas were analysised.Results: The results of correlation of artery stenosis and hypertension showed that notonly the intracranial arteries, but the extracranial artery stenosis, has a moderate correlationwith hypertension. Compared with the extracranial artery stenosis (r=0.503),theintracranial arterial stenosis has a closer correlation with hypertension (r=0.667).According the CTA results,the244cases were divided into two groups:thenone-cerebral artery stenonsis group and cerebral stenosis group. The results showed thatthe average age, systolic blood pressure levels in none-cerebral artery stenonsis group arelower than that of the cerebral artery stenosis group (p <0.05), the level of HDL in serum innone-cerebral artery stenonsis group is higher than that of the cerebral stenosis group.TheNHISS score, glycerol,cholesterol and LDL level, diastolic blood pressure of the twogroup have no significant difference. Based on the cerebral artery stenosis site of CTAresults,the patients were further divided into four groups: the pure intracranial artery stenosis group, pure extracranial artery stenosis group, none artery stenosis group,intracranial and the extracranial artery stenosis group. The results showed that the level ofsystolic blood pressure of pure intracranial artery stenosis group was significantly higherthan that of the none-cerebral artery stenosis group (p <0.05). The level of the bloodpressure has a positive relationship with the degree of arterious stenosis. the higher bloodpressure in the patients of artery stenosis were more difficult to be controlled than noneartery stenosis group by antihypertensive drugs. Conpared to other groups,thenone-cerebral artery stenosis patients have a younger age at onset and a lower level ofblood glucose and a higher serum HDL level,but NHISS score, triglycerides, cholesterol,LDL and diastolic blood pressure have no significant difference among groups. Usingextracranial arterial and intracranial arterial stenosis respectively as dependent variables inmultivariate unconditional logistic regression analysis showed that the risk of hypertensionwas1.136in the extracranial artery stenosis model and1.697in the intracranial arterialstenosis model, suggesting that the high blood pressure patients are more easier to sufferintracranial arterial stenosis than extracranial artery stenosis.Conclusion: The hypertension patient has a closely relationship with cerebral arterystenosis in ischemic stroke patients.The hypertension patients are more easier to sufferintracranial arterial stenosis than extracranial artery stenosis.