摘要
Abstract
Objective To investigate the characteristics of intracranial arterial wall plaques in patients with acute ischemic stroke caused by intracranial atherosclerotic stenosis(ICAS)using high resolution magnetic resonance vessel wall imaging(HR-MRI VWI)technique,and to explore the correlation between plaque characteristics and the different pathogenetic mechanisms.
Methods A retrospective analysis was made on patients with acute ischemic stroke caused by ICAS,who were admitted to the Department of Neurology,Beijing Tsinghua Changgung Hospital from January 2017 to April 2023.The pathogenetic mechanisms of acute ischemic stroke caused by ICAS was divided into the following four categories:parent artery atherosclerosis occluding perforator arteries mechanism,artery-to-artery embolism mechanism,hypoperfusion mechanism,and mixed mechanism.The clinical data of patients were collected,and HR-MRI VWI was used to obtain the characteristics of intracranial arterial wall plaques,including maximum wall thickness,stenosis rate,plaque burden,remodeling index,intraplaque hemorrhage,and irregular plaque surface.Differences in intracranial arterial wall plaque characteristics among patients with different pathogenetic mechanisms of acute ischemic stroke caused by ICAS were compared.Multivariate logistic regression analysis was used to investigate the correlation between plaque characteristics and different pathogenetic mechanisms.
Results A total of 204 patients were enrolled in this study with a mean age of(67.5±11.0)years,including 130 males(63.73％).There were statistically significant differences in the characteristics of intracranial arterial wall plaques among patients with acute ischemic stroke caused by ICAS with different pathogenetic mechanisms.Multivariate logistic regression analysis showed that irregular plaque surface was associated with the parent artery atherosclerosis occluding perforator arteries mechanism.The maximum wall thickness,intraplaque hemorrhag,irregular plaque surface,and remodeling index were associated with the artery-to-artery embolism mechanism.The maximum wall thickness,intraplaque hemorrhag,irregular plaque surface,and remodeling index were associated with the hypoperfusion mechanism.Irregular plaque surface and remodeling index were associated with the mixed mechanism.
Conclusions Patients with acute ischemic stroke caused by ICAS with different pathogenetic mechanisms have relatively specific characteristics of intracranial arterial wall plaque.HR-MRI VWI technique is helpful for clinically distinguishing different pathogenetic mechanisms of acute ischemic stroke caused by ICAS.关键词
缺血性卒中/高分辨率磁共振血管壁成像/动脉粥样硬化/发病机制Key words
Ischemic stroke/High resolution magnetic resonance vessel wall imaging/Atherosclerosis/Pathogenetic mechanism分类
医药卫生
