Feng Chao, Hua Ting, Xu Yu, Liu Xue-Yuan, Huang Jing
Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai, China.
Neurol Sci. 2015 Apr;36(4):547-51. doi: 10.1007/s10072-014-1994-z. Epub 2014 Nov 4.
Isolated pontine infarctions are usually classified as paramedian pontine infarction (PPI) and lacunar pontine infarction (LPI). Although they have different shapes and locations, some recent studies proved that they might both be associated with basilar artery atherosclerosis in pathogenesis. This study aimed to explore the difference of basilar artery remodeling between two subtypes of pontine infarctions. Patients with PPI or LPI were scanned by High-resolution MRI (HR-MRI). The MR images of patients with basilar artery atherosclerosis were further analyzed to measure the vessel, lumen and wall areas at different segments of basilar arteries. Stenosis rate and remodeling index were calculated according to which arterial remodeling was divided into positive, intermediate and negative remodeling. Vascular risk factors and remodeling-related features were compared between PPI and LPI, and also between patients with and without positive remodeling. 34 patients with PPI and 21 patients with LPI had basilar artery atherosclerosis identified by HR-MRI. Positive remodeling was dominant in LPI group while in PPI group, three subtypes of remodeling were equal. Patients with positive remodeling had higher levels of low-density lipoprotein and homocysteine. Positive remodeling of basilar artery might reflect the low stability of basilar atherosclerotic plaques, which was more closely associated with LPI than PPI.
孤立性脑桥梗死通常分为脑桥旁正中梗死（PPI）和腔隙性脑桥梗死（LPI）。尽管它们的形状和位置不同，但最近的一些研究证明，它们在发病机制上可能都与基底动脉粥样硬化有关。本研究旨在探讨两种脑桥梗死亚型之间基底动脉重塑的差异。对PPI或LPI患者进行高分辨率磁共振成像（HR-MRI）扫描。对基底动脉粥样硬化患者的磁共振图像进行进一步分析，以测量基底动脉不同节段的血管、管腔和管壁面积。根据这些计算狭窄率和重塑指数，据此将动脉重塑分为正向、中间和负向重塑。比较PPI和LPI之间以及有和没有正向重塑的患者之间的血管危险因素和重塑相关特征。34例PPI患者和21例LPI患者经HR-MRI检查发现有基底动脉粥样硬化。正向重塑在LPI组中占主导地位，而在PPI组中，三种重塑亚型相等。有正向重塑的患者低密度脂蛋白和同型半胱氨酸水平较高。基底动脉的正向重塑可能反映了基底动脉粥样硬化斑块的低稳定性，这与LPI的关系比与PPI的关系更密切。
