Wu Fang, Zhang Qian, Dong Kai, Duan Jiangang, Yang Xiaoxu, Wu Ye, Zhang Ling, Li Debiao, Fan Zhaoyang, Yang Qi
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Ther Adv Neurol Disord. 2019 Feb 26;12:1756286419833295. doi: 10.1177/1756286419833295. eCollection 2019.
Large-vessel atherosclerotic disease is an important pathogenesis of deep-perforator infarction (DPI). However, altered vessel walls of intracranial large arteries and distribution of small arteries in DPI are unclear because of the limited resolution of current imaging techniques. In this study the intracranial plaque burden and lenticulostriate artery (LSA) distribution in patients with recent DPI and non-DPI using whole-brain vessel-wall imaging (WB-VWI) were investigated.
A total of 44 patients with recent DPI (23 patients) or non-DPI (21 patients) due to intracranial atherosclerotic disease were prospectively enrolled. WB-VWI was performed in all the patients using a three-dimensional T1-weighted vessel-wall magnetic resonance technique. Hemispheres with DPI and non-DPI were considered as the DPI group and non-DPI group, respectively. Hemispheres without a history of stroke were the control group. The intracranial plaque burden was compared between the DPI and non-DPI groups. The number and length of visualized LSA branches among DPI, non-DPI, and control groups were also evaluated.
A total of 77 hemispheres were analyzed (23 in the DPI group, 21 in the non-DPI group, and 33 in the control group). Plaque burden was lower ( = 0.047) in the DPI group (82.0 ± 45.9 mm) compared with the non-DPI group (130.9 ± 90.3 mm). There was a significant reduction ( = 0.002) in length of visualized LSA branches in the DPI group (74.1 ± 21.7 mm) compared with the control group (104.6 ± 33.3 mm).
WB-VWI enables the combination of vessel-wall and LSA imaging in one image setting, which can provide information about plaque burden and LSA distribution.
大血管动脉粥样硬化疾病是深部穿支梗死(DPI)的重要发病机制。然而,由于当前成像技术分辨率有限,DPI 中颅内大动脉血管壁改变及小动脉分布尚不清楚。本研究采用全脑血管壁成像(WB-VWI),对近期发生 DPI 和未发生 DPI 的患者的颅内斑块负荷及豆纹动脉(LSA)分布进行了研究。
前瞻性纳入 44 例因颅内动脉粥样硬化疾病导致近期发生 DPI(23 例)或未发生 DPI(21 例)的患者。所有患者均采用三维 T1 加权血管壁磁共振技术进行 WB-VWI。发生 DPI 和未发生 DPI 的半球分别作为 DPI 组和非 DPI 组。无卒中病史的半球作为对照组。比较 DPI 组和非 DPI 组的颅内斑块负荷。同时评估 DPI 组、非 DPI 组和对照组中可见的 LSA 分支数量及长度。
共分析 77 个半球(DPI 组 23 个,非 DPI 组 21 个,对照组 33 个)。与非 DPI 组(130.9±90.3mm)相比,DPI 组(82.0±45.9mm)的斑块负荷更低(P = 0.047)。与对照组(104.6±33.3mm)相比,DPI 组可见的 LSA 分支长度显著缩短(P = 0.002)(74.1±21.7mm)。
WB-VWI 能够在同一图像设置中实现血管壁和 LSA 成像的结合,可提供有关斑块负荷和 LSA 分布的信息。