Li Yutian, Feng Quanzhi, Wang Congcong, Zhang Xianchang, Wan Liang, Han Tong
Department of Radiology, Tianjin Huanhu Hospital, Tianjin University, Tianjin, China.
Department of Radiology, Qingdao Women and Children's Hospital, Qingdao, Shandong, China.
Front Neurol. 2023 May 30;14:1179730. doi: 10.3389/fneur.2023.1179730. eCollection 2023.
We aimed to explore imaging indicators for diagnosing the etiology of single small subcortical infarctions (SSI) using high-resolution vessel wall imaging (HR-VWI).
Patients with acute isolated subcortical cerebral infarction were prospectively enrolled and classified as having large artery atherosclerosis (LAA), stroke of undetermined etiology (SUD), or small artery disease (SAD). The infarct information, the cerebral small vessel disease (CSVD) score, morphological characteristics of the lenticulostriate arteries (LSAs), and plaque characteristics were compared between the three groups.
Seventy seven patients were enrolled (30 LAA, 28 SUD, and 19 SAD). The total CSVD score of the LAA ( = 0.001) and SUD groups ( = 0.017) was significantly lower than that of the SAD group. The number and total length of LSA branches in the LAA and SUD groups were shorter than in the SAD group. Moreover, the total length laterality index (LI) of the LSAs in the LAA and SUD groups was greater than in the SAD group. The total CSVD score and LI of total length were independent predictors for the SUD and LAA groups. The remodeling index of the SUD group was significantly higher than that of the LAA group ( = 0.002); positive remodeling was dominant in the SUD group (60.7%), whereas remodeling in the LAA group was primarily non-positive (83.3%).
SSI with and without plaques on the carrier artery may have different modes of pathogenesis. Patients with plaques may also have a coexisting mechanism of atherosclerosis.
我们旨在利用高分辨率血管壁成像（HR-VWI）探索诊断单个小皮质下梗死（SSI）病因的影像学指标。
前瞻性纳入急性孤立性皮质下脑梗死患者，并将其分为大动脉粥样硬化（LAA）、病因不明性卒中（SUD）或小动脉疾病（SAD）。比较三组之间的梗死信息、脑小血管疾病（CSVD）评分、豆纹动脉（LSA）的形态特征和斑块特征。
共纳入77例患者（30例LAA、28例SUD和19例SAD）。LAA组（=0.001）和SUD组（=0.017）的CSVD总分显著低于SAD组。LAA组和SUD组LSA分支的数量和总长度均短于SAD组。此外，LAA组和SUD组LSA的总长度侧别指数（LI）大于SAD组。CSVD总分和总长度LI是SUD组和LAA组的独立预测因素。SUD组的重塑指数显著高于LAA组（=0.002）；SUD组以阳性重塑为主（60.7%），而LAA组的重塑主要为非阳性（83.3%）。
载瘤动脉有斑块和无斑块的SSI可能具有不同的发病机制。有斑块的患者也可能存在动脉粥样硬化的共存机制。
