Liao Siyuan, Deng Zhezhi, Wang Yuge, Jiang Ting, Kang Zhuang, Tan Sha, Shan Yilong, Zou Yan, Lu Zhengqi
Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Neurol. 2018 Sep 20;9:657. doi: 10.3389/fneur.2018.00657. eCollection 2018.
Perforating Artery Infarcts (PAIs) can be divided into two subtypes based on their etiologies: branch Atheromatous Disease (BAD) and Lacunar Infarct (LI). Recent studies have shown that while both subtypes can be caused by large artery lesions, the different mechanisms that underlie their development are not clear. This study was designed to use High-Resolution Magnetic Resonance Imaging (HRMRI) to explore the differences that contribute to the occurrence of these two subtypes in large artery lesions in the anterior circulation. Fifty patients with an acute PAI in the anterior circulation were enrolled (32 BAD and 18 LI patients). The ipsilateral middle cerebral artery (MCA) was scanned with HRMRI to analyze the atherosclerosis plaques. Artery remodeling and plaque characteristics of MCA lesions were compared between the two subtypes. The rate of MCA lesions was significantly higher in BAD and substantially lower in LI ( = 0.033). LAs for the lumen areas in Bad, they were smaller than LI ( < 0.001), Additionally, the plaque area ( = 0.001) and plaque burden ( < 0.001) were superior in the BAD group. Most BAD patients displayed non-positive remodeling, while the great majority of LI patients showed positive remodeling ( < 0.001). In the anterior circulation, a considerable amount of BAD and LI share similarities with atherosclerotic plaques in large arteries. BAD patients mainly showed relatively large and stable atherosclerotic plaques in large arteries, while LI patients mainly exhibited relatively small and unstable atherosclerotic plaques. This clinical trial is a retrospective study and therefore does not require registration.
穿支动脉梗死（PAIs）可根据其病因分为两种亚型：分支动脉粥样硬化病（BAD）和腔隙性梗死（LI）。最近的研究表明，虽然这两种亚型都可能由大动脉病变引起，但其发展的不同机制尚不清楚。本研究旨在使用高分辨率磁共振成像（HRMRI）来探讨在前循环大动脉病变中导致这两种亚型发生的差异。纳入了50例前循环急性PAI患者（32例BAD患者和18例LI患者）。用HRMRI扫描同侧大脑中动脉（MCA）以分析动脉粥样硬化斑块。比较了两种亚型之间MCA病变的动脉重塑和斑块特征。BAD组中MCA病变发生率显著更高，而LI组则显著更低（P = 0.033）。对于BAD组的管腔面积，其小于LI组（P < 0.001）。此外，BAD组的斑块面积（P = 0.001）和斑块负荷（P < 0.001）更高。大多数BAD患者表现为非阳性重塑，而绝大多数LI患者表现为阳性重塑（P < 0.001）。在前循环中，相当数量的BAD和LI与大动脉中的动脉粥样硬化斑块有相似之处。BAD患者主要表现为大动脉中相对较大且稳定的动脉粥样硬化斑块，而LI患者主要表现为相对较小且不稳定的动脉粥样硬化斑块。 本临床试验是一项回顾性研究，因此无需注册。
