| Objective: To determine the relationship between the shape of middle cerebral artery(MCA)and plaque location using MRA and high-resolution MRI,and analyze the role of different vessel shapes in the developent of acute cerebral infarction.Methods: Patients diagnosed with acute cerebral infarction who underwent MRI and high-resolution MRI were collected from July 2015 to December 2015 in department of Neurology of General Hospital of Shenyang Military Region.Depending on the shape of MCA M1 portion on coronal of MRA,four different shapes are classified as folows: straight,U-shaped,?-shaped and S-shaped.The basic data of various vessel types including a total of 11 stroke risk factors such as sex,age,smoking,drinking,hypertension,diabetes,history of stroke,LDL,HDL,TG,TC were analyzed.High-resolution MRI was used to examine the plaque on the artery wall between different arteries.After ruling out obvious stenosis(stenosis rate > 50%)of MCA,according to the diameter of infarction lesion,we divided into less than 2cm group and more than 2cm group and the relationship between four different vessel shapes and MCA perforating occlusion was analyzed.Results: 202 MCA vessels were observed in 101 patients.Of which,there are 13 vascular occlusion,15 unclear vascular image,so a total of 28 vessels was removed.A total of 174 MCA vessels were included in the study and a total of 696 images were observed.We found 106 plaque in the 174 vessels.Among the patients there were sixty three male patients(62.4%)and thirty eight female patients(37.6%)and the mean age were 61.2±10.1 years.According to the MRA coronal image pattern,the numbers of the four types of vessels were as follow: 90 straight shape(51.7%),30 U-shape(17.2%),44?-shape(25.3%),10 S-shape(5.7%).There are 3 straight shape,1 U-shape,0 ?-shape,and 3 S-shape in hemorrhagic lesions.Statistical analysis of the basic data of various types of arteries showed no statistical significance,which show that the vascular shape may be primarily attributed to congenital,but not acquired factors.Furthermore,high resolution MRI analyzed the distribution of tube wall plaque.The results are as follows:(1)The relationship analysis between shape of MCA and with or without plaque of vascular wall,namely between non plaque group and plaque group showed that straight shape were less associated with plaque whereas ?-shape were more often associated with plaque,and the difference was statistically significant.(2)The analysis of distribution difference of upper and lower plaques of various types of vessels showed that the superior plaque was more closely associated with U-shaped arteries(P<0.05).Although ?-shaped arteries were more often associated with plaque,the plaque distribution has no regularity.After ruling out MCA obvious stenosis(stenosis rate >50%),patients of basal ganglia single infarction were selected.The analysis of different diameter of infarction lesion showed that a large area of infarction was more closely associated with U-shaped arteries(P<0.05).Based on previous studies,the MCA perforating artery located in the superior and dorsal wall,Superior plaque was more closely associated with U-shaped middle cerebral arteries which plug the mouth perforator,leading to the occurrence of MCA perforating infarction.Through the observation of bilateral MCA M1 segment on MRA imaging,we found that the left and right MCA shape is not completely symmetrical,even the shape is completely different.The difference may mirror the side preference of MCA ischemic stroke.Conclusions: 1.The shape of MCA M1 segment artery may be related to the location of atherosclerotic plaque.Straight shape was less often associated with plaque whereas ? shape was more often associated with plaque,and plaque distributions have no regularity.Superior plaque was more closely associated with U-shaped middle cerebral arteries.2.Different vessel shapes may be associated with deep perforating artery ischemic stroke events.Superior plaque was more closely associated with U-shaped middle cerebral arteries which plug the mouth perforator,leading to the occurrence of MCA perforating infarction. |
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