| Purpose: The main cause of ischemic stroke is the formation of intracranial atherosclerosis(ICAS)plaque.Early detection of plaque is of great significance to the prevention of ischemic stroke.In this study,highresolution vessel wall magnetic resonance imaging(VW-MRI)technology was used to directly observe the vascular wall.VW-MRI is currently the only non-invasive imaging technique for intracranial arterial walls.This study aims to explore the diagnosis of ICAS plaque by VW-MRI and the clinical value of evaluating the efficacy of statins.Methods: The images were collected using Philips Ingenia 3.0T magnetic resonance scanner.Obtain the imaging data of the subject’s craniocerebral vessel wall and collect the relevant clinical information.For those who have found plaques,they were reviewed after 6 months of regular statin treatment.Compare the changes of plaque before and after treatment.Use Philips workstation to reconstruct the surface of the VWMRI image to obtain related information such as the distribution,shape and signal of the plaque.Vessel Explorer vessel wall plaque analysis software was used for plaque analysis.Obtain the following data: wall thickness,lumen area,wall area,the area of lipid-rich necrotic core/calcification/intraplaque hemorrhage area,fibrous cap thickness,normalized wall index,degree of vascular stenosis,eccentricity index and so on.Comparing the difference between responsible plaques,possible responsible plaques and non-responsible plaques in patients with ischemic stroke,comparing responsible plaques with asymptomatic plaques in the asymptomatic volunteer group.Determine the relevant image characteristics of the responsible plaque.Statistical analysis was performed with SPSS 23.0 software.Results: A total of 42 plaques were found in the ischemic stroke patient group(19 responsible plaques,7 possibly responsible plaques,and16 non-responsible plaques).There were 10 asymptomatic plaques in the asymptomatic volunteer group.There is no difference between the responsible plaque and the possible responsible plaque in the following aspects(p>0.05): plaque eccentricity,surface irregularity,plaque burden,signal heterogeneity,calcification,intraplaque hemorrhage,minimum fiber cap thickness,and degree of lumen stenosis.Compared with non-responsible plaques,responsible plaques have more irregular surface(p<0.05),greater plaque burden(p<0.05),more heterogeneous signals(p<0.05),and more intraplaque hemorrhage(p<0.05).The minimum fiber cap thickness of responsible plaques is smaller(p<0.05),and the degree of lumen stenosis is more serious(p<0.05).The plaque eccentricity(p>0.05)and calcification rate(p>0.05)has no difference between responsible plaque and non-responsible plaque.Compared with asymptomatic plaques,the responsible plaque surface is more irregular(p<0.05),the plaque burden is greater(p<0.01),the signal is more heterogeneous(p<0.05),and there is more intraplaque hemorrhage in the plaque(p<0.05),the minimum fiber cap thickness is smaller(p<0.05),the degree of lumen stenosis is more serious(p<0.05).There is no difference in plaque eccentricity(p>0.05)and calcification rate(p>0.05)between responsible plaque and asymptomatic plaques.After treatment,the plaque burden becomes smaller(p<0.05),the area of lipid necrosis nucleus becomes smaller(p<0.05),and the area of intraplaque hemorrhage becomes smaller(p<0.05).Compared with the plaque before treatment,the plaque after treatment had no significant changes in plaque eccentricity,surface irregularity,signal heterogeneity,calcification area,minimum fiber cap thickness,and lumen stenosis(p>0.05).Conclusion:(1)VW-MRI can identify the characteristics of responsible plaques.It helps to determine the risk of ischemic stroke.(2)VW-MRI can observe the changes of intracranial atherosclerotic plaque before and after treatment with statins,which can be used to judge the curative effect. |
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