Gao Tianli, Yu Wei, Liu Chunjie
Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.
Exp Ther Med. 2014 May;7(5):1415-1419. doi: 10.3892/etm.2014.1600. Epub 2014 Mar 4.
High-resolution magnetic resonance imaging (HRMRI) has a unique ability to provide an evaluation of the intracranial artery wall. This study aimed to investigate the possible mechanisms of ischemic stroke in patients with intracranial atherosclerosis using HRMRI. HRMRI was performed on 55 patients (38 male and 17 female) with acute cerebral infarction to investigate the lumen-intruding plaque at the stenotic portion of the middle cerebral artery (MCA) and basilar artery (BA) and to attempt to identify the mechanisms of stroke. Penetrating artery disease (PAD) was diagnosed in 20 patients (36%) and large-artery atherosclerosis (LAA) was diagnosed in 35 patients, including 19 with parent artery plaques occluding a penetrating artery (POPA; 35%) and 16 with artery-to-artery embolisms (29%). Patients with PAD had a higher frequency of hypertension compared with that of the patients with LAA (80 versus 29%; P<0.001), and patients with LAA had a higher frequency of diabetes compared with that of the patients with PAD (40% versus 15%; P=0.054). Magnetic resonance angiography revealed mild to moderate stenosis in the patients with POPA, while border zone infarction and artery-to-artery embolism occurred in the majority of the patients with severe stenosis or occlusion of the MCA and BA. HRMRI has the ability to identify the mechanisms of intracranial atherosclerotic ischemic stroke through the detection of luminal plaques.
高分辨率磁共振成像（HRMRI）具有评估颅内动脉壁的独特能力。本研究旨在利用HRMRI探讨颅内动脉粥样硬化患者缺血性卒中的可能机制。对55例急性脑梗死患者（男38例，女17例）进行HRMRI检查，以研究大脑中动脉（MCA）和基底动脉（BA）狭窄部位的管腔内突出斑块，并试图确定卒中机制。20例患者（36%）诊断为穿支动脉疾病（PAD），35例诊断为大动脉粥样硬化（LAA），其中19例为母动脉斑块阻塞穿支动脉（POPA；35%），16例为动脉到动脉栓塞（29%）。与LAA患者相比，PAD患者高血压发生率更高（80%对29%；P<0.001），与PAD患者相比，LAA患者糖尿病发生率更高（40%对15%；P=0.054）。磁共振血管造影显示，POPA患者存在轻至中度狭窄，而MCA和BA严重狭窄或闭塞的大多数患者发生了边缘带梗死和动脉到动脉栓塞。HRMRI能够通过检测管腔内斑块来识别颅内动脉粥样硬化缺血性卒中的机制。
