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Compared with routine imaging examination, magnetic resonance vascular wall imaging (MR-VWI) has the advantages of non-invasive and accurate in the diagnosis and differentiation of moyamoya disease and atherosclerotic moyamoya syndrome, and is of great significance in guiding clinical treatment and predicting outcomes. This article reviews the features of MR-VWI in moyamoya disease and atherosclerotic moyamoya syndrome.
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Objective:To investigate the correlation between vascular wall characteristics and ischemic stroke and its mechanism in patients with atherosclerotic middle cerebral artery (MCA) stenosis.Methods:Patients with atherosclerotic MCA stenosis received high-resolution vessel wall imaging (HR-VWI) in Shenzhen Bao'an District People's Hospital from November 2017 to November 2018 were enrolled retrospectively. The imaging characteristics, such as the lumen and vessel diameter and vessel wall area at the narrowest level of MCA plaque, plaque load, remodeling index, and plaque enhancement rate were measured. A multivariate logistic regression model was used to identify the independent risk factors for stroke in patients with atherosclerotic MCA stenosis. Results:A total of 53 patients with atherosclerotic MCA stenosis were enrolled, aged (53.5±9.7) years, 28 were male (52.8 %). There were 28 in the stroke group and 25 in the non-stroke group. Thirteen patients were artery-artery embolization, 15 were non-artery-artery embolization; 39 were mild stenosis, and 14 were moderate to severe stenosis. Compared with the non-stroke group, the moderate to severe stenosis was more common in the stroke group ( P=0.010), the plaque load was greater ( P=0.006), and the remodeling index was lower ( P=0.010). Multivariate logistic regression analysis showed that the remodeling index was an independent risk factor for stroke in patients with atherosclerotic MCA stenosis (odds ratio 0.002, 95% confidence interval 0.000-0.952; P=0.048). Compared with the non-artery-artery embolization group, the mean thickness of MCA was larger in the artery-artery embolization group ( P=0.037). Compared with the mild stenosis group, the plaque load was greater ( P=0.001), the plaque enhancement rate was higher ( P=0.004), and remodeling index was lower ( P<0.001) in the moderate to severe MCA stenosis group. Conclusions:In the atherosclerotic MCA stroke group, patients with moderate to severe stenosis are more common, with greater plaque load and lower remodeling index. Remodeling index is an independent risk factor for ischemic stroke. Patients with moderate to severe MCA stenosis have a higher plaque enhancement rate and a lower remodeling index, suggesting that the vessel wall inflammatory response is more significant and had decompensation. HR-VWI is expected to be used to assess the pathogenesis of ischemic stroke events.
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With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.
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Vessel wall magnetic resonance imaging (VW-MRI) is a non-invasive imaging method for evaluating intracranial atherosclerotic plaques,which can effectively distinguish the morphology and composition of atherosclerotic plaques.This article reviews the application of VW-MRI in the evaluation of intracranial atherosclerotic plaque.
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@#Objective To apply Canadian Occupational Performance Measure (COPM) on the patients injured in Sichuan Earthquake. Methods COPM was applied to evaluate 51 patients in hospital before and 1 months after treatment. The first evaluation confirmed the problems on occupational activities for them. Then the plan was made to solve the problems. The second evaluation was to assess the effect of the treatment.Results The problem of self-care activity is more than that of productive activities and leisure activities(P<0.01). Total scores of performance of occupational activity and satisfaction improved(P<0.01, P<0.01)Conclusion COPM is helpful to confirm the problems of occupational activities and contribute to develope the primary goals for rehabilitation and treatment programs.
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@#Objective To explore the rehabilitation for amputation and paraplegia. Methods A case with both lower limbs and left arm amputation complicated with L1 complete spinal cord injury was reported. Results Her participation improved after rehabilitation. Conclusion It is important to improve the participation under the limit of activity.