关键词:

CT血管成像, 高分辨率核磁共振成像, 后循环缺血, 斑块

Abstract:

Objective　To explore the characteristics of intracranial arterial wall plaques on plain CT angiography (CTA) and high-resolution magnetic resonance imaging (HR-MRI) in patients with posterior circulation ischemia. Methods　One hundred patients with posterior circulation ischemia treated at Liaocheng Third People's Hospital from March 2019 to May 2023 were selected, including 49 patients with transient ischemic attack (TIA) and 51 patients with cerebral infarction. There were 58 males and 42 females; they were (57.76 ± 8.92) years old. The CTA judgment of cerebral vascular stenosis and collateral circulation and the detection of plaques by CTA and HR-MRI were analyzed. The differences in HR-MRI plaque parameters between the with patients TIA and cerebral infarction were analyzed. The consistency analysis was conducted using Kappa test. The differences between groups were analyzed using t test or χ² test. Results　The Kappa value of the results of CTA judging cerebral vascular stenosis compared to digital subtraction angiography (DSA) was 0.761 (P<0.05); the accuracy of CTA in judging cerebral vascular stenosis was 85.00% (85/100). The Kappa value of CTA in determining cerebral vascular collateral circulation compared to DSA was 0.820 (P<0.05); the accuracy of CTA in determining cerebral vascular collateral circulation was 91.00% (91/100). The detection rates of plaques in the patients with cerebral infarction by CTA and HR-MRI were 92.16% (47/51) and 90.20% (46/51), respectively, which were higher than those in the patients with TIA [77.55% (38/49) and 73.47% (36/49)] (χ²=4.181 and 4.737; both P<0.05). Comparison of HR-MRI plaque parameters: the plaque area of cerebral infarction, plaque load, and remodeling index in the patients with cerebral infarction were higher than those in the patients with TIA [(5.86±0.92) mm² vs. (3.94±0.82) mm²,(26.17±4.82)% vs. (21.14±4.43)%, and (1.19±0.19) vs. (1.10±0.20)], with statistical differences (t=-11.001, -5.427, and -2.308; all P<0.05). The proportions of positive remodeling, vulnerable plaques, and plaques located on the ventral or upper wall in the patients with cerebral infarction were higher than those in the patients with TIA [82.35% (42/51) vs. 63.27% (31/49), 72.55% (37/51) vs. 34.69% (17/49), and 76.47% (39/51) vs. 36.73% (18/49)], with statistical differences (χ²=4.619, 14.417, and 16.099; all P<0.05). Conclusions　CTA has certain value in judging cerebral vascular stenosis and collateral circulation in patients with posterior circulation ischemia. At the same time, there are significant differences in HR-MRI plaque parameters between patients with TIA and cerebral infarction of posterior circulation ischemia.

Key words:

CT vascular imaging, High resolution nuclear magnetic resonance imaging, Posterior circulation ischemia, Plaques