Evaluation of symptomatic middle cerebral arterial atherosclerotic plaque by three dimensional-sampling perfection with application optimized contrasts using different flip angle evolutions of high-resolution magnetic resonance imaging / 中华神经科杂志

ABSTRACT

Objective To analyze characteristics and clinical significance of affected and unaffected side plaques in patients with symptomatic middle cerebral artery (MCA) atherosclerosis by three dimensional-sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) of 3.0 T high-resolution magnetic resonance imaging (MRI).Methods During the period from September 2016 to June 2017,31 patients admitted to the Peking University Aerospace School of Clinical Medicine were enrolled in this study.Routine MRI and high-resolution MRI were performed respectively.Patient's affected and unaffected sides were distinguished based on the conventional MRI on the presence or absence of signs of ischemia.The characteristics of bilateral MCA plaques were studied by high-resolution MRI 3D-SPACE sequences.The stenosis rate,plaque load,eccentricity index were quantitatively analyzed,and the degree of plaque enhancement and remodeling were qualitatively analyzed.Results Thirty-one MCAs in affected and unaffected sides were respectively collected,and 124 MCA plaques and reference plane images were obtained.Among all the patients,tihe MCA in unaffected side was larger in lumen area and had atherosclerotic plaques,and some MCAs had varying degrees of thickening of the wall.The stenosis rate,plaque burden and significantly enhanced plaque proportion of MCA in affected side were significantly higher than those in unaffected side (stenosis rate76.2％ ± 11.5％ vs 51.7％ ± 13.1％,t =7.801,P＜0.01;plaque burden81.6％ ±8.0％ vs 56.7％ ±13.9％,t =8.614,P＜0.01;significantly enhanced plaque proportion50.0％ (13/26) vs 0 (0/26),x2 =17.333,P＜ 0.01).There was no statistically significant difference in plaque distribution between the two sides.Positive remodeling blood vessels had more vessel area than negative remodeling blood vessels ((13.8 ± 2.9) mm2 vs (11.3 ± 2.8)mm2,t =2.389,P =0.024).Conclusion The high resolution MRI 3D-SPACE sequence clearly shows the MCA wall and plague,and can analyze the enhancement degree and morphological features of affected and unaffected side atherosclerotic plaques simultaneously,thus it is beneficial for risk stratification assessment and individualized treatment for stroke Patients in clinical practice.