Correlation Analysis Between Cerebral Infarction Lesions And Vascular Imaging Findings

Objective: To explore the correlation between responsible infarction foci and vascular imaging findings in patients with acute cerebral infarction,and to provide some theoretical basis for the diagnosis and treatment of patients with cerebral infarction and individual differences in secondary prevention.Methods: The cases were selected from 220 patients with cerebral infarction undergoing head and neck CTA and(or)craniocerebral MRA at the Department of Neurology,the First Affiliated Hospital of China Medical University admitted from 2015-10 to 2017-12,including 100 mismatched cases in which cerebral infarction foci and vascular lesions shown by angiography were unmatched,and 120 matching cases in which cerebral infarction foci and vascular lesions shown by angiography were matched.All the subjects fulfilled the diagnostic criteria of the " Guidelines for diagnosis and treatment of acute ischemic stroke in China 2016",and were confirmed as recent cerebral infarction by head CT and(or)brain DWI examination,no thrombolysis and / or thrombectomy were performed in the time window,and the subjects' clinical symptoms and signs were consistent with imaging findings.General information(including gender,age,history of hypertension,history of diabetes,history of smoking and alcohol abuse),laborator y tests(including blood tests,blood coagulation,blood glucose,blood lipids,homocysteine,etc.),head and neck CTA or(and)brain MRI findings.The above data were retrospectively for all cases analyzed to explore the correlation betweethe responsible infarction foci of patients with cerebral infarction and arterial stenosis and occlusion shown by head and neck CTA or(and)craniocerebral MRA,in order to provide some theoretical basis for further clarifying the treatment of acute cerebral infarction an d individual differences of secondary prevention.Results:1.In the mismatched groups,there were 39 cases in which head and neck artery CTA and craniocerebral MRA did not show the responsible vascular stenosis(39.0%)and 61 cases showing non-responsibility vascular stenosis or occlusion but not showing responsibility vascular stenosis or occlusion(61.0%).In the matched group,there were 79 cases(65.8%)showing non-responsibility vascular stenosis besides responsibility vascular stenosis.2.When comparing the affected status of cerebral cortex,there were 46 cases(38.3%)of purely medullary involvement and 74 cases(61.7%)of both the cortex and medulla involvement in the matching group.There were 86 cases(86.0%)of only medulla involvement and 14 cases(14.0%)of both the cortex and medulla involvement in the.?2 = 51.7,p <0.01,the difference was statistically significant.It indicates that when only the medulla was involved in the anterior circulation infarction,there was more mismatch phenomenon between cerebral infarction foci and vascular imaging results.3.When comparing the TOAST subtypes of the two groups,there were 29 cases(24.2%)of the small artery occlusion type in the matching group and 57 cases(57.0%)of the small artery occlusion in the mismatching group.?2 = 24.7,p <0.01,the difference was statistically significant;There were 9 cases(7.5%)of the branches artery occlusion type in the matched group and 35 cases(35.0%)of the branches artery occlusion type in the mismatched group.?2 =25.8,p<0.01,the difference was statistically significant.It indicates that there was more mismatched phenomenon between cerebral infarction foci and vascular imaging results in small artery occlusion type and branches artery occlusion type of cerebral infarction.Conclusion:1.In the patients with cerebral infarction accompanied by atherosclerosis,the positive rate of intracranial vascular stenosis was high in CTA and MRA examination,but the phenomenon of mismatch between infarction foci and vascular stenosis is common.2.When cerebral infarction was not involved in the cerebral cortex,CTA and craniocerebral MRA in the head and neck of the head were found to have a low ratio of responsible blood vessels.3.In patients with acute cerebral infarction,for the occlusion of arterioles type and perforator artery occlusion of the atherosclerosis type,head and neck CTA and brain MRA are difficult to detect effective positive results.