Li Ming-Li, Lin Qian-Qian, Liu Yi-Tong, Hou Bo, Feng Feng, Jin Zheng-Yu, Xu Wei-Hai
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongchengqu, Beijing 100730, China.
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongchengqu, Beijing 100730, China.
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105062. doi: 10.1016/j.jstrokecerebrovasdis.2020.105062. Epub 2020 Jul 1.
To study the feasibility and clinical utility of head-neck joint high-resolution vessel wall imaging (HNJ-VWI) in the assessment of ischemic stroke.
We reviewed our institutional HNJ-VWI database. Patients with transient ischemic attack (TIA) or ischemic stroke were included. Abnormal findings of intracranial and/or extracranial artery were assessed on three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) and HNJ-VWI modified from high-resolution 3D T1 sequence and classified into three groups including intracranial, extracranial and coexisting based on the locations. Etiologies of stroke were recorded according to Trial of Org 10172 in Acute Stroke Treatment criteria.
One hundred and ten consecutive patients were studied. 3D TOF MRA displayed 71.8% (79/110, based on patients) abnormal arteries (stenosis or occlusion) , while HNJ-VWI displayed 96.3% (106/110) abnormal arteries (plaque,wall thickness and occlusion) including four isolated extracranial lesions and ten coexisting lesions. The etiologies of TIA/ischemic stroke included large artery atherosclerosis (80 cases), cerebral small vessel disease (6 cases), cardiogenic (2 cases), dissection (6 cases), vasculitis (4 cases), moyamoya disease (6 cases), others (2 cases) and undetermined (4 cases). For patients with atherosclerosis stroke, re-infarctions were more common in coexisting group than intracranial group (extracranial vs. intracranial vs coexisting: 0% vs. 9.1% vs. 43.7%, p = 0.001).
HNJ-VWI is a feasible and valuable technique in assessment of ischemic stroke by detecting extracranial and intracranial artery abnormalities with one-step scan.
研究头颈部关节高分辨率血管壁成像（HNJ-VWI）在缺血性卒中评估中的可行性及临床应用价值。
回顾我们机构的HNJ-VWI数据库。纳入短暂性脑缺血发作（TIA）或缺血性卒中患者。在三维时间飞跃磁共振血管造影（3D TOF MRA）及基于高分辨率3D T1序列改良的HNJ-VWI上评估颅内和/或颅外动脉的异常表现，并根据位置分为颅内、颅外和并存三组。根据急性卒中治疗中Org 10172试验标准记录卒中病因。
连续研究110例患者。3D TOF MRA显示71.8%（79/110，基于患者）的动脉异常（狭窄或闭塞），而HNJ-VWI显示96.3%（106/110）的动脉异常（斑块、管壁厚度及闭塞），包括4例孤立的颅外病变和10例并存病变。TIA/缺血性卒中的病因包括大动脉粥样硬化（80例）、脑小血管病（6例）、心源性（2例）、夹层（6例）、血管炎（4例）、烟雾病（6例）、其他（2例）及病因不明（4例）。对于动脉粥样硬化性卒中患者，并存组再梗死比颅内组更常见（颅外组 vs. 颅内组 vs. 并存组：0% vs. 9.1% vs. 43.7%，p = 0.001）。
HNJ-VWI是一种可行且有价值的技术，通过一次扫描检测颅外和颅内动脉异常来评估缺血性卒中。
