| Objective:To analyze the characteristics of vascular wall between criminal and non criminal vessels of the middle cerebral artery(MCA)by using 3.0 Tesla HR MRI and the relationship between the location of plaque distribution and type of infarction was analyzed to infer the possible mechanisms of stroke.Methods:We recruited 64 patients who met the inclusion criteria from the Second Affiliated Hospital of Nanchang University from September 2014 to March 2017.All patients had scanned with conventional MRI which including T1 WI,T2WI,T2-FLAIR,3D-TOF-MRA,DWI,and then scanned with HR MRI in the targeted MCA.All patients scanned confirmed or suspected MCA diagnosed by MRA using 3.0T(GE,Signa,3.0T,Excite,HD,Systems)GE8 channel coils.The enrolled patients were divided into symptomatic and asymptomatic patients and then the scanned vessels were divided into criminal and non criminal vessels according to the responsible vessel of infarction.We collected the clinical information,laboratory examinations,plaque characteristics,stenosis degree and infarction patterns to analyze the clinical characteristics between symptomatic and asymptomatic groups,and the plaque characteristics between criminal and non criminal vessels.The relationship between location distribution of plaque and the infraction pattern was analyzed to infer the possible mechanisms of stroke.All data were analyzed by SPSS 17.0.Results:1.A total of 64 patients were enrolled(including 45 males and 19 females,the average age was 59±12 years,age range: 26-87 years)and 76 cases MCA were scanned in our study.Among them,43 cases were symptomatic patients and 21 cases were asymptomatic patients.44 cases of scanned MCA were criminal vessels,the others were non criminal vessels.The average age of the symptomatic group was 60±14 years while non symptomatic group was 58±7 years.There was no statistical significance in age and gender between two groups(P>0.05).In addition,the past history(including the history of diabetes,hypertension,hyperlipidemia,hyperhomocysteinemia,smoking)and laboratory results(total cholesterol,triglyceride and low-density lipoprotein)were not statistically significant(P>0.05).2.The plaque characteristics including LA(2.28±1.69 VS 2.31±1.61,P= 0.807),WA(5.70±2.43 VS 5.32±1.58,P= 0.444),VA(7.95±2.97 VS 7.69±2.49,P=0.844),PB(0.72±0.17 VS 0.72±0.16,P=0.883),RI(0.75±0.25 VS 0.81±0.24,P=0.324),stenosis degree(P=0.715),remodeling patterns(P=0.854),location distributions(superior P=0.845,inferior P=0.084,ventral P=0.966,dorsal P=0.389),irregular surface(P=0.873)and plaque stability(P=0.283)were not differ statistically(P>0.05)between the criminal and non criminal groups.But the thickening pattern was significantly difference(P<0.05),eccentric thickening was more common in two groups and the rate in criminal group was higher.3.In the distribution of scanned plaques,there were 32 cases(42.1%)situated in superior wall,30 cases(39.5%)situated in inferior ventral wall,7 cases(9.2%)situated in ventral wall and 7 cases(9.2%)situated in dorsal wall.The results showed that the probability of no infractions was high when plaque located on the superior and dorsal wall,as well as the sub-cortical infarction was common when plaques located on the inferior and ventral wall.The plaques of all patients with massive cerebral infarction were only located on superior wall,but the difference was not differ statistically(P>0.05).4.The gender distribution of the included 76 MCA was male 53 cases(69.7%),female 23 cases(30.3%)and there was no significant difference at different positions(P>0.05).Conclusion:In patients with MCA stenosis,eccentric thickening was possible associated with unstable plaque.The distributions of plaque may be helpful to determine the types of infarction and understand the underlying mechanism of ischaemic events,especially the plaque situated in superior wall. |
