High-resolution MRI features in patients with ischemic stroke caused by vertebral artery dissection / 中华放射学杂志

ABSTRACT

Objective:To explore high-resolution MRI (HR-MRI) characteristics in patients with ischemic stroke caused by vertebral artery dissection.Methods:A total of 47 patients with suspected vertebral artery dissection in the First People′s Hospital of Lianyungang, Kangda College, Nanjing Medical University from June 2015 to June 2020 were consecutively enrolled. All patients underwent routine MRI before HR-MRI, and three-dimensional arterial spin labeling (3D-ASL) was performed in those with negative MR. Patients with posterior circulation infarction on MRI and ischemic hypoperfusion on 3D-ASL were included in the ischemic stroke group, while patients with negative plain MRI and normal 3D-ASL were included in the normal group. The clinical characteristics and HR-MRI imaging characteristics between the two groups were compared using t-test or χ 2 test, while the correlations of quantitative data or ranked data were analyzed by Pearson or Spearman test. Results:There were 27 patients in the ischemic stroke group and 20 patients in the normal group, and there were no significant differences in clinical characteristics such as gender, age, site of onset, history of hypertension, hyperlipidemia, and history of diabetes between the two groups ( P>0.05). Basilar artery lateral deviation classification (χ2 =7.013, P=0.030), basilar lateral bend angle (140°±19° vs. 137°±15°, t=2.231, P<0.026), minimum bending angle of vertebral basilar artery (131°±27° vs. 90°±13°, t=42.630, P<0.001), the minimum bending angle of vertebrobasilar artery ≤ 90° distribution (3 cases vs. 21 cases, χ2=15.240, P<0.001) and effective lumen index (0.33±0.10 vs. 0.17±0.09, t=35.934, P<0.001) of normal group and ischemic stroke group showed statistically significant differences. Among them, the minimum bending angle of the vertebrobasilar artery was negatively correlated with posterior circulation ischemic hypoperfusion ( r=-0.621, P<0.001), and the effective lumen index was negatively correlated with posterior circulation ischemic stroke ( r =-0.713, P<0.001). However, the location of the dissection, the distribution of hematoma, the shape of the lumen and the enhancement type were not statistically significant between the normal group and ischemic stroke group ( P>0.05). Conclusion:HR-MRI shows that the lateral deviation of the basilar artery of grade 3, the minimum bending angle of the vertebrobasilar artery less than 90°, and small effective lumen index are related to posterior circulation stroke caused by vertebral artery dissection, which may help for the proper formulation of clinical treatment plan.