| Objective:To explore the value of 3.0T high resolution magnetic resonance imaging(HR MRI)in young patients with intracranial vascular stenosis?Methods:The research contains 84 young patients who underwent 3.0T HR MRI examination from January 2018 to January 2020 in the Department of medical imaging of The Second hospital of Hebei Medical University.The clinical and imaging data of intracranial arterial stenosis in young patients were recorded,and the high-risk factors,etiology and imaging characteristics of intracranial arterial stenosis in young patients were discussed.Results:1?Among 84 patients with intracranial arterial stenosis,48 patients had intracranial atherosclerosis(57.1%),30 had central nervous system vasculitis(35.7%),and 6 had moyamoya disease(7.1%),the incidence of intracranial atherosclerosis was the highest.In this group,there were 57 males,accounting for 67.9%;27 females,accounting for 32.1%,the incidence of males was higher than that of females.2?Divided into groups of less than 35 years old and older than 35 years old by age,a total of 44 patients under the age of 35,including 20 patients with intracranial atherosclerosis(45.45%),21 with central nervous system vasculitis(47.73%),and 3 with moyamoya disease(6.82%),atherosclerosis and central nervous system vasculitis have similar incidence;A total of 40 cases in the ?35-year-old group,including 28 cases of intracranial atherosclerosis(70.0%),9 cases of central nervous system vasculitis(22.5%),and 3 cases of moyamoya disease(7.5%),the incidence of intracranial atherosclerosis is significantly higher than other causes.3?Among the 57 male patients,37 were intracranial atherosclerosis(64.91%),17 were central nervous system vasculitis(29.82%),and 3 were moyamoya disease(5.26%),young males had the most intracranial atherosclerosis common causes;Of the 27 female patients,11 had intracranial atherosclerosis(40.74%),13 had central vasculitis(48.15%),and 3 had moyamoya disease(11.11%),the etiology of intracranial artery stenosis in young women was widespread.4?The 84 clinical risk factors included 39 cases of hypertension(46.4%),26 cases of smoking(31.0%),19 cases of hyper-Hcyemia(22.6%),15 cases of rheumatoid immunity(17.9%),and 15 cases of alcohol consumption(17.9%),13 cases of hyperuricemia(15.5%),11 cases of diabetes(13.1%),10 cases of hyperlipidemia(11.9%);A comparative analysis of the above factors according to the group less than 35 years old and the group 35 years or older found that: the proportion of rheumatoid immune abnormalities in the group <35 years old is higher than the group ?35 years old(27.3% vs 7.5%);The proportion of hyperuricemia in the <35-year-old group is higher than that in the ?35-year-old group(25.0% vs 5.0%);the proportion of diabetes in the <35-year-old group is lower than that in the ?35-year-old group(2.3% vs 25%);The proportion of rheumatoid immune abnormalities in CNS vasculitis was significantly higher than that of atherosclerosis and moyamoya disease(73.33% vs 26.67% vs 0%),and the difference was statistically significant(P <0.05).5?Intracranial arterial stenosis involved blood vessels,30 cases(68.2%)involving a single vessel and 14 cases(31.8%)involving multiple vessels in the <35-year-old group;16 cases(40.0%)involved a single vessel,and 24 cases(60.0%)involved a multivessel in the ?35-year-old group,the difference between the two groups was statistically significant(P <0.05),indicating that the proportion of single vessels was higher in the age group <35 years,and the proportion of multivessels was involved in the ?35-year-old group high;In the <35-year-old group,intracranial arterial stenosis involved only 40 cases(90.9%)of the anterior circulation,4 cases(9.1%)of the posterior circulation,and 0 cases of anterior and posterior circulation;In the ?35-year-old group,30 cases(75.0%)were involved in the anterior circulation,4 cases(10.0%)were involved in the posterior circulation,and 6 cases(2.9%)were involved in the anterior and posterior circulation,the difference between the two groups was statistically significant(P <0.05),indicating that the proportion of the group with the age less than 35 years old which simply involved the anterior circulation is higher than the group with the age ?35 years old,the proportion of post-circulation involvement was higher in the ?35-year-old group.Intracranial arterial stenosis caused by different etiologies involving single or multiple vessels,and anterior and posterior circulation of intracranial arterial stenosis caused by different etiologies were not statistically significant(P?0.05).In this group of 84 patients,7 patients(8.3%)with intracranial arterial stenosis and non-smog vascular network formation(excluding moyamoya disease)were not statistically significant at different ages and genders(P?0.05).6?19 patients with central nervous system vasculitis were followed up by hormonal therapy,with a 9-month threshold.9 months were treated in 11 cases of remission,and 8 cases were not,there were no significant differences between the two groups in different ages,genders,and different high-risk factors(P?0.05).Conclusion:1?HR MRI is of great value in identifying the etiology and evaluating the efficacy of intracranial arterial stenosis.2 ? The cause of intracranial arterial stenosis in young people is atherosclerosis,followed by central nervous system vasculitis and moyamoya disease.The incidence of intracranial arterial stenosis in men is higher than that in women.3?The incidence of atherosclerosis in patients with intracranial artery stenosis less than 35 years of age is similar to that of central nervous system vasculitis,but the proportion of atherosclerosis in patients with intracranial artery stenosis over 35 years of age is significantly higher.4?The most important cause of intracranial artery stenosis in young men is intracranial atherosclerosis,while the etiology of intracranial artery stenosis in young women is widespread.5?Hypertension,smoking,hyper-Hcyemia,rheumatoid immune disorders,alcohol consumption,hyperuricemia,diabetes,and hyperlipidemia are high-risk factors for intracranial arterial stenosis.Among them,the incidence of diabetes is significantly higher in the ?35-year-old group than < 35-year-old group,the incidence of rheumatoid immune disorders and hyperuricemia was significantly lower in the ?35-year-old group than in the <35-year-old group;central nervous system vasculitis was significantly associated with rheumatoid immune abnormalities.6?Intracranial arterial stenosis is more common in single vessels,with previous circulation as the main disease,with age,it gradually expands to multiple vessels and posterior circulation;There was no significant correlation between the involvement of single or multiple vessels and anterior and posterior circulation in different causes of intracranial arterial stenosis.Intracranial arterial stenosis in young people may be associated with the formation of non-smoky blood vessel networks,which should be paid attention to.7?Hormones are an effective treatment for central nervous system vasculitis,and half of them begin to relieve in 9 months. |
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