磁共振成像2025，Vol.16Issue(8)：25-31,7.DOI:10.12015/issn.1674-8034.2025.08.005
急性缺血性脑卒中患者Willis环完整性与斑块特征及多发梗死的相关性研究
Correlation between Willis ring integrity and plaque characteristics and multiple infarctions in patients with acute ischemic stroke
摘要
Abstract
Objective:Based on high-resolution magnetic resonance vascular wall imaging analysis of Willis ring integrity,responsible plaque characteristics,infarct foci,and plaque numbers in patients with anterior circulation acute ischemic stroke,to explore the correlation between Willis ring integrity and plaque vulnerability,multiple infarctions,and plaque numbers.Materials and Methods:Retrospective analysis of 85 patients with acute ischemic stroke in the anterior circulation who visited Our hospital from January 2022 to December 2023,all of whom underwent high-resolution magnetic resonance angiography within 14 days of symptom onset.And based on the integrity of the Willis ring,it was divided into two groups.Compare the clinical data and intracranial responsible plaque characteristics between two groups of anterior circulation and posterior circulation,respectively.Use Single factor and multiple factor binary logistic regression analysis to evaluate the correlation between Willis ring integrity and plaque coexistence,as well as multiple infarctions.Spearman and multiple linear regression analysis were used to evaluate the correlation between Willis loop integrity and plaque number,as well as enhancement level.Results:The group with incomplete Willis anterior circulation had higher plaque burden(P=0.001),enhancement rate(P=0.043),greater stenosis of responsible vessels(P=0.001),and more irregular plaque surfaces(P=0.001).Compared with the intact symptom side group of the Willis loop,the incomplete symptom side group of the Willis loop had a higher plaque burden(P=0.002),greater degree of responsible vessel stenosis(P=0.001),and more irregular plaque surfaces(P=0.013).Univariate logistic regression analysis showed that the incomplete anterior circulation of Willis ring was independently associated with multiple infarcts(OR=2.94,95%CI:1.153 to 7.478,P=0.024).Spearman analysis showed that the incomplete anterior circulation of Willis ring was positively correlated with the enhancement level(r=0.321,P<0.05);Another incomplete group was positively correlated with the number of plaques and the enhancement level(r=0.358,0.302;P<0.05).Age,gender and clinical risk factors were adjusted,including smoking history,drinking history,hyperlipidemia,hypertension,and diabetes.The results of multiple logistic regression analysis showed that incomplete anterior circulation of Willis was independently associated with multiple infarctions(OR=3.42,95%CI:1.208 to 9.700,P=0.021).Multiple linear regression analysis showed that incomplete anterior circulation of Willis was a factor affecting the enhancement level(β=0.571,P<0.05),while incomplete posterior circulation of Willis was a factor affecting the number of plaques and enhancement level(β=0.791,0.341;P<0.05).Conclusions:Incomplete Willis ring will promote plaque vulnerability,multiple infarcts and atherosclerosis in multiple vascular beds.This indicates that the loss of integrity of the Willis ring may affect the hemodynamics of the extracranial and extracranial great arteries,thereby affecting the blood supply of brain tissue and atherosclerosis process.关键词
急性缺血性脑卒中/多发性梗死/Willis环/责任斑块/血管壁成像/磁共振成像Key words
acute ischemic stroke/multiple infarction/Willis ring/responsibility plaque/vascular wall imaging/magnetic resonance imaging分类
医药卫生引用本文复制引用
王泽华,高阳,吴琼,何金龙,张强,郝祥程,王丽雯..急性缺血性脑卒中患者Willis环完整性与斑块特征及多发梗死的相关性研究[J].磁共振成像,2025,16(8):25-31,7.基金项目
Natural Science Foundation of Inner Mongolia(No.2023QN08055). 内蒙古自治区自然科学基金项目(编号:2023QN08055) （No.2023QN08055）
