The Application Study Of HRMR-VWI In The Diagnosis Of Posterior Circulation Arterial Lesions

Objective: To explore the diagnostic value of high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)for vertebral-basal artery diseases.Methods:A retrospective analysis of 61 patients with complete data and images that met the diagnostic requirements during the period from December 2018 to December 2019 in the Brain Neurology Center of the Second Affiliated Hospital of Xinjiang Medical University.The subjects were divided into atherosclerotic acute cerebral infarction group and non-atherosclerotic lesion group.The atherosclerotic acute cerebral infarction group is then responsible for the vascular positive remodeling group and the negative remodeling group.The non-atherosclerotic components were divided-into three groups: vasculitis,artery dissection,and aneurysm.(1)Finally,36 patients with acute cerebral infarction caused by atherosclerosis were included.HRMRVWI T1-VISTA sequence scan + enhanced examination were performed to measure the responsible blood vessel and the reconstruction index of the responsible blood vessel was calculated(RI=The blood vessel area at the narrowest point/the blood vessel area at the reference point).Compare the plaque area and load of positive and negative reconstructed blood vessels,and observe the location,distribution and enhancement characteristics of responsible plaque.(2)Finally,25 patients with non-atherosclerosis patients were enrolled.HRMR-VWI T1-VISTA sequence flat scan and enhanced examination were performed to evaluate the changes of the vessel wall and the etiology of the lesion.Results:(1)HRMR-VWI found that among the 36 patients with acute cerebral infarction due to atherosclerosis in the posterior circulation,there were 23 basilar atherosclerotic plaques and 13 vertebral artery(intracranial)atherosclerotic plaques.There were 21 cases of positive reconstruction of responsible vessels,13 cases of negative reconstruction,and 2 cases of no reconstruction.The plaque area and load of the positive reconstruction group were larger than those of the negative reconstruction group.Vertebrobasilar atherosclerotic plaques mostly occur around the opening of the branch of the perforating artery,more commonly in the dorsal aspect.The atherosclerotic plaques in the vertebroba-silar artery system are mostly mildly or obviously strengthened.(2)Of the 25 patients with posterior circulation non-atherosclerosis,6 patients had primary central nervous system vasculitis,accounting for 11.5%,and showed a thickening of the wall of the tube,which was markedly strengthened;12 cases of vertebral-basal artery dissection,Accounting for 23.1%,with intimal flap,double-lumen sign,and dissection opening;7 cases of aneurysm,accounting for 13.4%,5 cases occurred in vertebral artery,2 cases occurred in basilar artery,HRMR-VWI clearly showed the thickness of the tumor wall and Strengthen features.Conclusion: HRMR-VWI can provide important information for the etiology and treatment plan of vertebrobasilar artery disease,and it is an important method for the examination of vertebral basilar artery disease.