Volume 22 Issue 6
Jun.  2024
Turn off MathJax
Article Contents
SHI Jingjing, BAO Jieyu, ZHANG Jing, CAI Mengmeng, CHAO Linlin, ZHAO Jianhua. Effect of atherosclerotic plaque characteristics of middle cerebral artery on cerebral infarction caused by arterial stenosis[J]. Chinese Journal of General Practice, 2024, 22(6): 962-965. doi: 10.16766/j.cnki.issn.1674-4152.003544
Citation: SHI Jingjing, BAO Jieyu, ZHANG Jing, CAI Mengmeng, CHAO Linlin, ZHAO Jianhua. Effect of atherosclerotic plaque characteristics of middle cerebral artery on cerebral infarction caused by arterial stenosis[J]. Chinese Journal of General Practice, 2024, 22(6): 962-965. doi: 10.16766/j.cnki.issn.1674-4152.003544

Effect of atherosclerotic plaque characteristics of middle cerebral artery on cerebral infarction caused by arterial stenosis

doi: 10.16766/j.cnki.issn.1674-4152.003544
Funds:

 SBGJ202102034

  • Received Date: 2023-05-20
    Available Online: 2024-07-22
  •   Objective  To explore the correlation between vessel wall characteristics and infarction patterns in patients with atherosclerotic stenosis of the middle cerebral artery (MCA) using high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) and diffusion-weighted imaging (DWI).  Methods  A retrospective study was conducted at the People's Hospital of Zhengzhou University from January 2021 to December 2022, involving 68 patients with acute ischemic stroke in the MCA due to atherosclerotic stenosis. Patients were categorized into single-and multiple-infarct groups based on DWI findings, and various atherosclerosis risk factors, degree of lumen stenosis, and plaque characteristics were compared between the two groups. Logistic regression analysis was performed to assess the relationship between vessel wall properties and infarct patterns in MCA atherosclerotic stenosis patients.  Results  Among 68 patients with atherosclerotic stenosis in the middle cerebral artery, 45 patients (66.18%) had multiple infarcts, and 23 (33.82%) had single infarcts. There were no significant difference in age, sex, hypertension, diabetes, hyperlipidemia, smoking history, cardiovascular disease history, cerebrovascular disease history and NIHSS score between the two groups (P>0.05). Degree of stenosis and prevalence of intraplaque hemorrhage (IPH) were significantly greater in the multiple-infarction group than those in the single-infarction group (degree of stenosis: P=0.029; IPH: P=0.025). There was no significant difference in eccentricity and plaque enhancement between the two groups (P>0.05). After adjusting for age, sex, hypertension, diabetes, hyperlipidemia, smoking history, cardiovascular disease history, cerebrovascular disease history, NIHSS score and other confounding factors, logistic regression analysis showed that IPH (adjusted OR=6.525, 95% CI: 1.108-38.442, P= 0.038) was independent predictor for multiple infarction.  Conclusion  IPH is independently associated with multiple infarcts. HRMR-VWI may provide new insight into the mechanisms underlying the different MCA infarction patterns.

     

  • loading
  • [1]
    GUTIERREZ J, TURAN T N, HOH B L, et al. Intracranial atherosclerotic stenosis: risk factors, diagnosis, and treatment[J]. Lancet Neurol, 2022, 21(4): 355-368. doi: 10.1016/S1474-4422(21)00376-8
    [2]
    LIANG W B, YIN J Q, LU C Y, et al. Endovascular re-canalization for symptomatic non-acute intracranial large artery occlusion: a single-center retrospective study[J]. Quant Imaging Med Surg, 2023, 13(12): 8031-8041. doi: 10.21037/qims-23-643
    [3]
    FAKIH R, ROA J A, BATHLA G, et al. Detection and quantification of symptomatic atherosclerotic plaques with high-resolution imaging in cryptogenic stroke[J]. Stroke, 2020, 51(12): 3623-3631. doi: 10.1161/STROKEAHA.120.031167
    [4]
    PRABHAKARAN S, LIEBESKIND D S, COTSONIS G, et al. Predictors of early infarct recurrence in patients with symptomatic intracranial atherosclerotic disease[J]. Stroke, 2021, 52(6): 1961-1966. doi: 10.1161/STROKEAHA.120.032676
    [5]
    JING J, MENG X, ZHAO X Q, et al. Dual antiplatelet therapy in transient ischemic attack and minor stroke with different infarction patterns: subgroup analysis of the CHANCE randomized clinical trial[J]. JAMA Neurol, 2018, 75(6): 711-719. doi: 10.1001/jamaneurol.2018.0247
    [6]
    彭斌, 吴波. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004

    PENG B, WU B. Chinese Guidelines for Diagnosis and Treatment of acute ischemic Stroke 2018[J]. Chinese Journal of Neurology, 2018, 51(9): 666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004
    [7]
    DEL BRUTTO V J, CHATURVEDI S, DIENER H C, et al. Antithrombotic therapy to prevent recurrent strokes in ischemic cerebrovascular disease: JACC scientific expert panel[J]. J Am Coll Cardiol, 2019, 74(6): 786-803. doi: 10.1016/j.jacc.2019.06.039
    [8]
    ALMALLOUHI E, NELSON A M, COTSONIS G, et al. Ameliorating racial disparities in vascular risk factor management with aggressive medical management in the SAMMPRIS trial[J]. Stroke, 2023, 54(9): 2235-2240. doi: 10.1161/STROKEAHA.122.042055
    [9]
    宋明慧, 岳云龙, 郭劲松, 等. MRI 3D SNAP序列对大脑中动脉斑块内出血的研究[J]. 中国医学影像学杂志, 2021, 29(2): 131-135. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYZ202102009.htm

    SONG M H, YUE Y L, GUO J S, et al. Three-dimentional simultaneous noncontrast angiography and intraplaque hemorrhage imaging sequence of MRI in the intraplaque hemorrhage of atherosclerotic middle cerebral artery[J]. Chinese Journal of Medical Imaging, 2021, 29(2): 131-135. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYZ202102009.htm
    [10]
    CROMBAG G A J C, SCHREUDER F H B M, VAN HOOF R H M, et al. Microvasculature and intraplaque hemorrhage in atherosclerotic carotid lesions: a cardiovascular magnetic resonance imaging study[J]. J Cardiovasc Magn Reson, 2019, 21(1): 15. doi: 10.1186/s12968-019-0524-9
    [11]
    孙钦峰, 刘莹, 钱菊, 等. 椎动脉斑块内出血引起反复后循环缺血性脑卒中1例报道[J]. 神经损伤与功能重建, 2023, 18(5): 307-310. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKF202305014.htm

    SUN Q F, LIU Y, QIAN J, et al. One case of recurrent posterior circulation ischemic stroke caused by intravertebral artery plaque hemorrhage was reported[J]. Neural Injury and Functional Reconstruction, 2023, 18(5): 307-310. https://www.cnki.com.cn/Article/CJFDTOTAL-GWKF202305014.htm
    [12]
    LIBBY P. The changing landscape of atherosclerosis[J]. Nature, 2021, 592(7855): 524-533. doi: 10.1038/s41586-021-03392-8
    [13]
    WU F, SONG H Q, MA Q F, et al. Hyperintense plaque on intracranial Vessel Wall magnetic resonance imaging as a predictor of artery-to-artery embolic infarction[J]. Stroke, 2018, 49(4): 905-911. doi: 10.1161/STROKEAHA.117.020046
    [14]
    田雪, 黄柳, 姚菁青, 等. 血清脂蛋白相关磷脂酶A2水平与颈动脉粥样硬化斑块的相关性分析[J]. 中华全科医学, 2022, 20(11): 1848-1851. doi: 10.16766/j.cnki.issn.1674-4152.002717

    TIAN X, HUANG L, YAO J Q, et al. Correlation analysis between serum Lp-PLA2 level and carotid atherosclerotic plaque[J]. Chinese Journal of General Practice, 2022, 20(11): 1848-1851. doi: 10.16766/j.cnki.issn.1674-4152.002717
    [15]
    ZHANG N, LYU J H, REN L J, et al. Arterial culprit plaque characteristics revealed by magnetic resonance Vessel Wall imaging in patients with single or multiple infarcts[J]. Magn Reson Imaging, 2021, 84: 12-17. doi: 10.1016/j.mri.2020.06.004
    [16]
    SUN B B, WANG L L, LI X, et al. Intracranial atherosclerotic plaque characteristics and burden associated with recurrent acute stroke: a 3D quantitative Vessel Wall MRI study[J]. Front Aging Neurosci, 2021, 13: 706544. DOI: 10.3389/fnagi.2021.706544.
    [17]
    SHI Z, LI J, ZHAO M, et al. Progression of plaque burden of intracranial atherosclerotic plaque predicts recurrent stroke/transient ischemic attack: a pilot follow-up study using Higher-Resolution MRI[J]. J Magn Reson Imaging, 2021, 54(2): 560-570. doi: 10.1002/jmri.27561
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(4)

    Article Metrics

    Article views (105) PDF downloads(10) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return