The Study About Application Of HR-MRI In Big Intracranial Artery Stenosis

Background:Cerebral infarction has become the leading cause of physical disability in people over the age of 60,and the second leading cause of death in the world's population.As far as the world is concerned,atherosclerosis is likely to be the leading cause of stroke.Atherosclerosis can occur in any blood vessel,with carotid arteries predominant in Europe and the United States,and intracranial arteries in Asians.In recent years,with the improvement of people's material living standards and lifestyle changes,atherosclerosis has become younger.Therefore,the current research hotspot is:how to use imaging technology to detect atherosclerotic plaque early,and accurately measure the degree of primary responsibility of vascular stenosis,in order to achieve early diagnosis and early prevention.High-Resolution Magnetic Resonance Imaging(HR-MRI)black blood technology(including double inversion,triple inversion sequence)has been widely used in the internal carotid artery and intracranial artery(mainly basilar artery and brain)The study of the arterial wall imaging has two methods:the Warfarin-Aspirin Symptomatic Intracranial Disease trial(WASID)and the area measurement algorithm.So,what is the accuracy and diagnostic effectiveness of the two measurements?In response to the above problems,this study includes two aspects,high-resolution MR imaging of atherosclerosis caused by cerebral artery(MCA)stenosis of the lumen and wall imaging,in order to evaluate the two stenosis rates The accuracy of the measurement method and the diagnostic effectiveness.Part ? Accuracy evaluation of HR-MRI measurement of cerebral artery stenosis rateObjective;To evaluate the accuracy of Measurements of atherosclerotic middle cerebral artery(MCA)'s stenosis with 3.0T high-resolution magnetic resonance imaging(HR-MRI)technology.Materials and Methods:Forty patients with symptomatic middle cerebral artery(MCA)atherosclerotic stenosis confirmed by digital subtraction angiography(DSA)were scanned by HR-MRI sequence(including T1 WI,T2WI,PDWI).They enrolled in the Affiliated Hospital of Binzhou Medical College from September 2017 to May 2018.The MCA M1 stenosis rate(quantitative measurement)on HR-MR images using the warfarin-aspirin symptomatic intracranial artery disease test method(WASID method)and area measurement algorithm,respectively,and based on the stenosis rate The degree of stenosis(semi-quantitative measurement)was determined,and the accuracy of the two measurement methods was evaluated using the DSA as the gold standard.Result:The HR-MRI images of 30 patients who met the measurement requirements clearly showed the structure of the vessel wall.The inner edge of the vessel was clearly distinguishable and smooth,showing eccentric stenosis.The stenosis rate of MCA measured by DSA,WASID method and area measurement algorithm were(82±17)%,(70± 12)%,(81 ± 16)%,and the difference between MCA stenosis rate and DSA measured by area measurement algorithm.There was no statistical significance(P>0.005);the MCA stenosis rate measured by the area measurement algorithm was better correlated with DSA(r=0.893);the area measurement algorithm measured the stenosis degree to be higher(the coincidence rate was 90%).Conclusion:High-resolution MR imaging technology can display the wall condition.The area measurement algorithm has high accuracy in measuring the degree of MCA stenosis and has high clinical application valuePart ? Comparative study of HR-MRI with TCD,3D-TOF MRA and CTA in intracranial artery stenosisObject i ve:To explore the value of high resolution MR imaging in multimodal angiography of symptomatic intracranial artery stenosis.Mater ials and Methods:130 patients with symptomatic cerebral ischemia confirmed by conventional MR in our hospital were diagnosed as symptomatic intracranial artery stenosis(ICASS)and underwent transcranial Doppler ultrasound(TCD)and 3D-TOF magnetic resonance angiography(Five methods of 3D-TOF MRA),high-resolution magnetic resonance imaging(HR-MRI),3D-CT angiography(3D-CTA),and 3D-digital subtraction angiography(3D-DSA).The 3D-DSA diagnosis was used as the gold standard to compare the coincidence rate,accuracy,sensitivity and specificity of TCD,3D-TOF MRA,HR-MRI,and 3D-CTA diagnosis.Result:The coincidence rate of HR-MRI in the diagnosis of intracranial stenosis was 77.3%,the accuracy was 80.0%,the sensitivity was 89.7%,and the specificity was 92.9%.All indexes were the best.The coincidence rate of 3D-CTA in the diagnosis of intracranial stenosis was 76.4%,the accuracy was 79.6%,the sensitivity was 88.4%,the specificity was 90.6%,and the difference in accuracy between 3D-CTA and HR-MRI.There was no statistical significance(P>0.05),and the differences of other indicators were statistically significant(P<0.05).TCD can provide hemodynamic information of intracranial stenotic vessels more accurately.The coincidence rate of 3D-TOF MRA in the diagnosis of intracranial stenosis was 72.1%,the accuracy was 77.3%,the sensitivity was 74.8%,and the specificity was 78.0%.The indexes were the worst.Conclusion:High-resolution MR imaging technology has high accuracy in diagnosing symptomatic intracranial artery stenosis in multimodal angiography,and can display tube wall conditions,which has high clinical application value.