| Purpose:High resolution magnetic resonance imaging(HR-MRI)was used to observe the structure of intracranial arterial walll,further analyze its correlation with vascular risk factors and provide clinical basis for prevention and treatment of Ischemic stroke,and help to explore the mechanism of Ischemic stroke.Methods:240 patients with ischemic stroke in our hospital from May 2015 to December 2017 were collected.,PHILPS Achieva 3.0T magnetic resonance with 8 channel head coil was used to scan 3D-VISTA,HR-T2 WI,3D-TOF MRA and other sequences.The image reconstruction was performed on the MRI Systems Achieva Release workstation.The reconstruction area of middle cerebral artery was chosed at the M1 segment of the MCA,which is 8 mm near to the origin of anterior cerebral artery,and the reconstruction region of basilar artery was chosed at the position of BA,which is 8 near to the origin of the superior cerebellar artery.The clinical data of patients were collected,including age,sex,blood pressure,blood lipids(triglycerides,low density lipoprotein,total cholesterol),homocysteine,diabetes history,smoking history and so on.,Patients with incomplete clinical data,incomplete images and poor image quality were excluded.Finally,120 patients were included in the analysis.The wall parameters of MCA and BA reconstruction areas were systematically analyzed and measured,including vascular area(VA),lumen area(LA),wall area(WA),WA/LA ratio and standardized wall index(NWI).IBM SPSS 19 software was used to analyze and compare the correlation between regional vascular parameters and vascular risk factors in patients with IS.Results: a total of 120 patients with bilateral MCA M1 segment,BA,and bilateral posterior cerebral artery P1 segment were included in the analysis.There were 49 plaques,including bilateral MCA and 26 plaques,BA 19 plaques,and bilateral posterior cerebral arteries in 4 plaques.The location of MCA plaque was slightly larger than that of the inferior vascular wall,followed by the superior wall.BA plaques were most common on the left wall,followed by the dorsal wall.32 plaques were shown as equal or slightly high signal on 3D-VISTA sequence,and 14 patches on 3D-VISTA sequence showed mixed signal or slightly low signal.3 patches on 3D-VISTA and HR-T2 WI sequences showed high signal in the plaque,and the plaque signal on HR-T2 WI sequence was changeable,and 44 patches showed mixed signal and slightly high signal.2 plaques can be seen fiber cap and lipid core on HR-T2 WI.The correlation between regional vascular parameters and vascular risk factors of intracranial artery reconstruction in IS patients was analyzed and compared.BA had a larger WA than bilateral MCA(P<0.05).There was a significant difference between DM,HCY and WA in left MCA(P<0.05).There was a significant difference in the NWI between DM and left MCA,BA(P<0.05),and there was significant difference between HCY and left MCA NWI(P<0.05).HCY is an independent predictor of L-MCA WA and L-MCA NWI,and DM is an independent predictor of R-MCA NWI and BA-NWI.Age is an independent predictor of R-MCA WA and BA-WA(P<0.05).Conclusion:(1)there is a correlation between DM,blood HCY and WA,NWI in intracranial vessels,indicating that DM and HCY are related to thickening of the wall,which may lead to ICAD and even IS.(2)DM,blood HCY,sex and age are independent predictors of WA and NWI of bilateral MCA,BA.It is speculated that DM,blood HCY,sex and age are responsible for specific responsible vessels and can be quantified for the vessel wall condition.(3)3D-VISTA combined HR-T2 WI sequence can be applied to the early diagnosis of ICAD caused by vascular risk factors.It provides a clinical basis for the prevention and treatment of IS,and helps to explore the mechanism of IS. |
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