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The correlation between the characteristics of middle cerebral artery atherosclerotic plaque, cerebral perfusion and the occurrence of acute cerebral infarction
YAN Tianzhi  ZHANG Chao  LIU Qingxiang  HUANG Qi  HUANG Xianjun  ZHOU Yunfeng 

Cite this article as: Yan TZ, Zhang C, Liu QX, et al. The correlation between the characteristics of middle cerebral artery atherosclerotic plaque, cerebral perfusion and the occurrence of acute cerebral infarction[J]. Chin J Magn Reson Imaging, 2022, 13(5): 106-110. DOI:10.12015/issn.1674-8034.2022.05.019.


[Abstract] Objective To explore the high-risk plaque characteristics and perfusion parameters associated with acute cerebral infarction (ACI) in patients with symptomatic middle cerebral artery (MCA) atherosclerotic stenosis using high-resolution magnetic resonance vessel wall imaging (HRMR-VWI) and CT perfusion imaging (CTP).Materials and Methods The data of HRMR-VWI and CTP in 64 patients with symptomatic MCA atherosclerotic stenosis whose onset time was less than 4 weeks were analyzed retrospectively. According to diffusion weight imaging (DWI) and clinical manifestations, patients were divided into ACI group and transient ischemic attack (TIA) group. The differences of plaque characteristics, perfusion parameters and collateral grade between the two groups were analyzed. Multivariate Logistic regression and receiver operating characteristic (ROC) curve analysis were performed to evaluate the predictive performance and the AUC.Results A total of 64 patients were included.There were 25 patients [age: (55.12±11.20) y; 10 female] in TIA group and 39 patients [age: (57.90±9.62) y; 11 female] in ACI group. There was no significant difference in sex (P=0.327) and age (P=0.296) between the two groups. Compared with TIA group, the plaque length [6.10 (3.20, 12.3) mm vs. 4.10 (2.15, 5.55) mm; P=0.006], the burden [86.83% (80.26%, 100.00%) vs. 78.46% (72.70%, 87.66%); P=0.007], the degree of stenosis [86.76% (76.19%, 100.00%) vs. 75.72% (60.94%, 85.84%), P=0.008], the degree of enhancement (P＜0.001) and the enhancement index [(1.19±0.55) vs. (0.58±0.46); P＜0.001] were larger. Meanwhile, the values of relative mean transit time (rMTT) [(1.19±0.22) vs. (1.05±0.17); P=0.007], relative time to drain (rTTD) [(1.52±0.47) vs. (1.19±0.30); P=0.003], and relative time to the center of the impulse response function (rTmax) [(2.26±1.33) vs. (1.55±0.67); P=0.007] in ACI group were higher than those in TIA group. Multivariate Logistic regression analysis showed plaque length (OR=1.17, 95% CI: 1.001-1.362, P=0.049), the degree of enhancement (OR=5.18, 95% CI: 1.848-14.522, P=0.002) and rTmax (OR=2.32, 95% CI: 1.019-5.298, P=0.045) were significantly independent predictors of ACI. The prediction efficiency of the combination of plaque length, the degree of enhancement and rTmax was the best (AUC=0.862; 95% CI: 0.767-0.956).Conclusions HRMR-VWI combined with CTP can comprehensively evaluate the characteristics of symptomatic MCA atherosclerotic plaque and downstream perfusion state, which is helpful to identify patients with high-risk MCA atherosclerotic stenosis associated with ACI.
[Keywords] high-resolution magnetic resonance vessel wall imaging；computed tomography perfusion imaging；middle cerebral artery atherosclerotic；transient ischemic attack；acute cerebral infarction；magnetic resonance imaging

YAN Tianzhi1   ZHANG Chao1   LIU Qingxiang1   HUANG Qi1   HUANG Xianjun2   ZHOU Yunfeng1*  

1 Department of Radiology, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China

2 Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China

Zhou YF, E-mail: zhouyunfeng808@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS "Peak" Backbone Program of Scientific Research Ability of Yijishan Hospital of Wannan Medical College (No. GF2019G13).
Received  2021-12-07
Accepted  2022-03-23
DOI: 10.12015/issn.1674-8034.2022.05.019
Cite this article as: Yan TZ, Zhang C, Liu QX, et al. The correlation between the characteristics of middle cerebral artery atherosclerotic plaque, cerebral perfusion and the occurrence of acute cerebral infarction[J]. Chin J Magn Reson Imaging, 2022, 13(5): 106-110. DOI:10.12015/issn.1674-8034.2022.05.019.

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