Correlation Between Components And Characteristics Of Intracranial Atherosclerotic Plaques And Ischemic Stroke Evaluated By High-Resolution Magnetic Resonance Vessel Wall Imaging

Objective The purpose of this study is to apply high-resolution MRI vessel wall imaging(HRMR-VWI)to analyze the correlation between the components and characteristics of intracranial atherosclerotic plaques and ischemic stroke.Methods 78 patients with intracranial atherosclerotic stenosis were selected to collect their clinical data,blood biochemical indexes and NIHSS score.All patients were scanned by HRMR-VWI,and routine head scans such as T1 WI,T2WI and diffusion weighted imaging were improved.All images were analyzed and measured by two experienced chief physicians on MRI-Plaque View software.According to the results of MRI and the history of cerebral infarction,the patients were divided into three groups:acute / subacute cerebral infarction group,chronic cerebral infarction group and non-cerebral infarction group.The differences of clinical data and blood biochemical indexes among the three groups were compared,and the relationship between ischemic stroke and intracranial plaques was analyzed by multiple Logistic regression,and the differences of plaque composition and characteristics between responsible and irresponsible plaques were compared.The differences of components and characteristics of responsible plaque among acute / subacute,chronic and non-cerebral infarction groups were compared.The relationship between plaque composition and characteristics and ischemic stroke was analyzed by multiple Logistic regression,and the correlation between plaque composition and NIHSS score was explored by Spearman correlation analysis,and the distribution of intracranial atherosclerotic plaque in each branch was compared.Conclusion(1)Compared with patients without cerebral infarction,the probability of acute / subacute cerebral infarction in patients with 1 unit increase of plasma homocysteine was 0.302 times higher than that in patients without cerebral infarction(OR=1.302,P < 0.05),and the probability of chronic cerebral infarction in patients with increased unit of apolipoprotein A1 was 0.975 times lower than that in patients without cerebral infarction(OR=0.025,P < 0.05).The incidence of acute / subacute cerebral infarction in hypertensive patients was 12.511 times higher than that in non-hypertensive patients(OR=12.511,P < 0.05).(2)The ratio of calcification,Intraplaque Hemorrhage,IPH,thrombus,obvious enhancement,moderate and severe vascular stenosis,negative remodeling and plaque load in the responsible plaque group were significantly higher than those in the non-responsible plaque group.(3)The IPH rate,thrombus rate and plaque load of responsible plaque in acute / subacute cerebral infarction group were significantly higher than those in non-cerebral infarction group,and the probability of acute / subacute cerebral infarction in patients with 1 unit increase of plaque load was 0.414 times higher than that in patients without cerebral infarction(OR=1.414,P < 0.05).Spearman correlation analysis showed that there was a significant positive correlation between IPH,thrombus,plaque load and NIHSS score(rs > 0,P < 0.05).(4)There are the most plaques in the middle cerebral artery(54.5%),and the least plaques in the internal carotid artery(intracranial segment)(7.3%).Conclusion(1)The existence of IPH and thrombus is closely related to responsibility plaque and ipsilateral stroke events.(2)Larger plaque load can increase the risk of ischemic stroke,and the severity of stroke may be more severe and the prognosis may be worse.(3)HRMR-VWI can accurately identify the number,location and length of thrombus,which can provide important information for clinical determination of the best treatment strategy...