| ObjectiveUsing High resolution magnetic resonance imaging(HRMRI)to investigate the location of infarction and the characteristics of parent artery wall in patients with acute isolated perforating artery infarction,and to explore the type of yin and yang.Methods1.This study selected a case of isolated infarction in the acute perforating region of middle cerebral artery and basilar artery from those patients who were treated in Traditional Chinese Medicine Hospital of Guangdong Province from August 2012 to February 2019.2.Two experienced neurologists divided the data into the Lenticulostriate artery(LSA)group and the paramedian pontine artery(PPA)group according to the infarct position of the DWI.According to the plaque of the parent artery on the HRMRI,there were divided into plaque group and non-plaque group.According the wall of the different parent arteries and the location of the plaque,and whether it was strengthened or not by HRMRI,the data were analyzed and divided into BAD and LI groups.The BAD group refers to the presence of enhanced plaques on the HRMRI of the opening of the perforator artery or at the beginning of the perforating artery.The LI group refers to the absence of crimanal plaque in the crimanal artery.3.According to the presence or absence of stenosis of the parent artery in magnetic resonance angiography(MRA),the stenosis group and the non-stenosis group were compared,and determine the proportion of the BAD and L.I.4.Comparative analysis of the risk factors and early neurological progression between the BAD group and the LI group were statistically significant.5.Analyze whether there is statistical significance in the classification of TCM yin and yang syndrome in BAD and LI groups.Results1.This study included 46 patients with sputum standard,20 patients in the LSA group,including 10 patients' plaques in the middle cerebral artery,1 patient in the ventral side of the wall,9 patients was located on the upper wall;and there were 10 patients without plaque.There were 26 patients in the PPA group,including 24 patients of atherosclerotic plaque in the basilar artery,21 patients in the dorsal side,2 patients in the side wall,and 3 patients in the plaque group.Using HRMRI to observe the arterial wall,33 cases of plaque group were found.The plaques were located near the opening of the perforating artery,and plaque enhancement was observed in the enhanced scan.Therefore,33 cases in the plaque group could be diagnosed as BAD.0 cases were diagnosed as LI;13 cases were no-plaque group,and 1 case had no plaque in the parent artery,but the beginning of the perforating artery showed high signal after the enhanced scan,indicating that the one was diagnosed as BAD,and the remaining 12 cases were diagnosed as LI.Therefore,this study used HRMRI to observe the artery wall found 34 patients in the BAD group,12 patients in the LI group.2.In this study,25 patients with no stenosis were observed by MRA,and 21 patients with stenosis.There were 13 BAD and 12 LI in non-stenosis group.There were 21 BAD and 0 LI in stenosis group.3.In this study,Among the various factors,the BAD group was older,which was 63.79±12.41,which was statistically significant compared with the age of 54.75±11.51 in the LI group(P<0.05).Diabetes in the BAD group accounted for 61.7%,significantly higher than the LI group(P<0.05).The early neurological deterioration in the two groups was diagnosed,14 cases in the BAD group and 1 case in the LI group.There was a significant difference between the two groups(P<0.05).There was no significant difference in gender,hypertension,TIA or ischemic stroke history,smoking history,triglyceride,total cholesterol,high-density lipoprotein,low-density lipoprotein and homocysteine(P>0.05).4.In this study,46 patients with acute perforating infarction,7 patients with yang type and 27 patients with yin type in the BAD group,2 patients with yang type and 10 patients with yin type in the LI group.There was no statistically significant difference between the two groups(x2=0.087,P=0.708>0.05).Conclusion1.High-resolution magnetic resonance is helpful for the diagnosis of branch atherosclerotic infarction and lacunar infarction;it has certain reference value for risk factor control and precise treatment in patients with acute isolated perforating artery infarction;2.There was no statistical significance between the atherosclerotic infarction and the yin and yang types,which reflected the difference between the microscopic thought of Western medicine and the overall concept of TCM. |
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