The Study Of MRI Characteristic Of Carotid Plaque And Related Risk Factors In Patients With Recurrent Acute Cerebral Infarction

Objective: Using 3.0T high resolution MRI technology,to compare the characteristics of carotid plaque in the patients with first-time or recurrent acute cerebral infarction,to judge plaque stability,the distribution of the carotid plaque and the extent of carotid artery stenosis in offending vessles and non-responsible vessels between two groups,and to explore the related risk factors of recurrent cerebral infarction,so as to help the clinician taking active treatment and preventing recurrence of cerebral infarction.Methods: 48 patients with acute cerebral infarction of anterior circulation from October 2013 to October 2014 in the department of neurology in Clinical College of Tianjin Medical University;the fourth central hospital were divided into two groups,22 patients in first cerebral infarction group and 26 patients in recurrence group.It was comparable between the two groups in general data such as sex and age.All the patients were performed bilateral carotid artery 3.0T MRI examination with 3D TOF bright blood,T1 WI,T2WI and 3D MP-RAGE black blood technology sequence.Scan results were analyzed to judge plaque stability,the distribution of plaque and the extent of carotid artery stenosis in offending vessles and non-responsible vessels between two groups.Check the National Institute of Health stroke scale scores,blood pressure,blood sugar level and other laboratory examinations.Collect the related risks in patients with previous history of smoking,hypertension,transient ischemic attack,diabetes,hyperlipidemia and other related risk factors.Using SPSS 21.0 statistical software,count data between two groups were compared with Chi-squared test,measurement data between two groups were compared with independent sample T-test,the difference was statistically significant when P<0.05.Results: 1.The carotid plaque of offending vessels comparison between the two groups:(1)Compared with first cerebral infarction group,the number of vulnerable plaque in recurrence group were significant improved(42.9% vs.12.5%,P<0.05)(2)Compared with first cerebral infarction group,the number of fibrous cap rupture(25% vs.4.2,P<0.05)and intraplaque hemorrhage(32.1% vs.4.2%,P<0.05)in recurrence group were significant improved.(3)the distribution of carotid plaque differences were no significant between two groups.(4)Compared with first cerebral infarction group,the number of severe stenosis in recurrence group were significant improved(40% vs.9.5%,P<0.05),however,the number of mild stenosis in first cerebral infarction group were were significant improved than recurrence group(66.7%vs.20%,P<0.05).2.The carotid plaque of non-responsible vessels comparison between the two groups: the stability of the carotid plaque,the distribution of the carotid plaque and the stenosis degree of carotid artery were no significant between two groups.3.The National Institute of Health stroke scale scores were higher in recurrence group than first cerebral infarction group,which had significant difference(5.23±2.05 vs.3.00±2.43,P<0.05).4.Age,sex,smoking,coronary heart disease and hypertension were no significant between two groups,however,systolic blood pressure was higher in recurrence group than first cerebral infarction group,which had significant difference(151.65±1.27 vs.139.10±1.87,P<0.05).Compared with first cerebral infarction group,transient ischemic attack,diabetes,fasting plasma glucose,hemoglobin A1 C,total cholesterol,low-density lipoprotein,homocysteine,C reactive protein and folate in recurrence group were significant improved(P<0.05),and high-density lipoprotein was significant lower in recurrence group than first cerebral infarction group(P<0.05).Diastolic blood pressure,triglycerides and vitamin B12 were no significant between two groups(P>0.05).Conclusion: 1.3.0T high resolution MRI can qualitatively analyze the stability of carotid plaque,which contributed to evaluate the risk of recurrent cerebral infarction.2.There was variability among two groups in the components of carotid plaque of offending vessels,the number of vulnerable plaque including fibrous cap rupture and intraplaque hemorrhage in recurrence group were significant improved.Compared with first cerebral infarction group,the number of severe stenosis in recurrence group were significant improved.3.The stability of the carotid plaque,the distribution of the carotid plaque and the stenosis degree of carotid artery were no significant between the two groups of non-responsible vessels.4.The National Institute of Health stroke scale scores were higher in recurrence group than first cerebral infarction group.5.Diabetes,transient ischemic attack,systolic blood pressure,hyperlipidemia,hyperhomocysteinemia,high C-reactive protein were the risk factors for recurrence of cerebral infarction,controlling these risk factors can prevent the recurrent of cerebral infarction.