The Value Of Posterior Circulation Atherosclerotic Plaque Features In High-resolution MR Imaging In Predicting The Risk Of Ischemic Stroke

Objective:To evaluation the value of posterior circulation atherosclerotic plaque features in high-resolution MR imaging in predicting the risk of ischemic stroke;And then combined analysis of clinical information and laboratory tests to provide more valueble information in the clinical scientific treatment and early intervention of ischemic stroke.Materials and Methods:One hundred and twenty-eight patients with posterior artery atherosclerotic plaques,including posterior circulation ischemic stroke(n=57)and non-posterior circulation ischemic stroke(n=69)were enrolled in our study.All patients' laboratory tests and clinical information were gathered and analyzed.High-resolution MR imaging(3DT1-SPACE)was performed in all patients,and the responsible posterior artery were qualitatively and quantitatively analyzed.The laboratory tests,clinical information,Plaque burden,plaque morphology,and plaque enhancement were compared between the ischemic stroke and non-ischemic stroke patients.All the potential risk components of posterior circulation ischemic stroke were determined by multiple Logistic aggression analysis Identifying independent risk factors for ischemic stroke.In addition,this study also classified non-ischemic stroke patients into positive and non-positive remodeling groups according to the type of remodelingpattern,and then compared the differences between other data.Results:(1)The ratio of hypertension in patients with posterior artery ischemic stroke were significantly higher than without(84.2% vs.52.2%)(P<0.001),whereas other clinical information including gender,age,hyperlipidemia,smoking and drinking,diabetes mellitus demonstrating statistically insignificant(all P>0.05).(2)The level of CRP in patients with posterior artery ischemic stroke were significantly higher than patients without(4.77mg/L vs.3.15 mg/L),but the level of HDL-C in patients with posterior artery ischemic stroke were significantly lower than the latter(0.98mmol/L vs.1.13mmol/L)(P< 0.05),but we found no statistically significant between people with and without posterior artery ischemic stroke in other laboratory tests including TG,TC,LDL-C,FIB and HCY(all P>0.05).(3)The lumen area(LA),lumen stenosis rate,wall area(WA),plaque burden index(PBI),and remording index(RI)were higher in patients with ischemic stroke than those patients without(P<0.001).However,there existed no statistically significance in reference total vessel area,reference lumen diameter,total vessel area(TVA),lumen diameter(LD)between the two groups(all P>0.05).(4)Patients with ischemic strokeowned a significantly greaterratio of positive recmording,irregular plaque surface,plaque eccentric distribution compared with those patients without(P<0.05).And the ratio of plaque diffuse thickening and intra-plaque high signal demonstratedno statistically significance between the two groups(P>0.05).The lumen stenosis degree in patients with posterior artery ischemic stroke were significantly greater than patients without(P=0.012).(5)Patients with posterior artery ischemic stroke owned a significantly higher prevalence and degree of plaque enhancement compared with those patients without(P=0.013).(6)HDL-C,CRP,irregular plaque surface,plaque eccentric distribution and positive recmording were independence dangerous factor in posterior circulation ischemic stroke.(7)Among the patients without ischemic stroke,the stenosis rate of the positive remodeling group were significantly lower than that of the non-positive remodeling group(13.66% vs.22.50%)(p=0.014),but,other laboratory texts,clinical information,plaque burden and plaque morphology between the two groupsshowing statistically insignificant(all P>0.05).Conclusions:(1)HDL-C,CRP,irregular plaque surface,plaque eccentric distribution and positive recmording were independent risk factors in posterior circulation ischemic stroke.(2)Among the patients without ischemic stroke,the stenosis rate of the positive remodeling group were significantly lower than that of the non-positive remodeling group.(3)The 3DT1-SPACE sequence can well depict the characteristics of posterior circulation atherosclerotic plaques.There is a certain difference in plaque burden,plaque morphology and plaque enhancement between the stroke group and the non-stroke group.These imaging features will be helpful for the early intervention and clinical scientific treatment in posterior artery ischemic stroke.