Association between characteristics of middle cerebral artery plaque and acute cerebral ischemia / 中华老年医学杂志

ABSTRACT

Objective:To investigate the relationship between atherosclerotic plaque characteristics of the middle cerebral artery(MCA)and acute cerebral ischemic symptoms by using high-resolution magnetic resonance imaging(HR-MRI).Methods:A retrospective analysis of clinical and imaging data was performed in 136 patients[100 males, aged(60.8±11.4)years]with MCA atherosclerotic plaque who underwent HR-MRI.Patients were divided into the acute symptomatic group(n=73)and the non-acute asymptomatic group(n=63)according to whether the patients had acute ischemic symptoms in the MCA territory within two weeks.The basic demographic characteristics, clinical risk factors, MCA plaque enhancement, maximum plaque length, maximum wall thickness, ratio of maximum plaque length to maximum wall thickness and luminal stenosis were compared between the two groups.Binary Logistic regression was used to estimate the association between MCA plaque characteristics and acute ischemic symptoms in the corresponding vascular territory.Results:Compared with the non-acute symptomatic group, the acute symptomatic group had a greater prevalence of diabetes mellitus(50.7% or 30/73 vs. 30.2% or 19/63, χ2=5.882, P=0.015), a higher occurrence of enhanced plaques(87.7 % or 64/73 vs.46.0% or 29/63, χ2=27.118, P<0.001), greater maximum plaque length[(6.7±3.7 mm) vs.(4.9±2.3)mm, t=-3.330, P=0.001], greater maximum wall thickness[(1.5±0.8)mm vs.(1.0±1.0)mm, t=-2.231, P=0.027]and more severe luminal stenosis[(66.4±31.3)% vs. (30.7±25.3) %, t=-7.354, P<0.001]. Logistic regression analysis showed that MCA enhanced plaque( OR=4.492, 95% CI: 1.762-11.449, P=0.002)and luminal stenosis( OR=1.032, 95% CI: 1.018-1.047, P<0.001)were independently associated with acute ischemic symptoms. Conclusions:Compared with luminal stenosis, MCA enhanced plaque has a stronger correlation with acute ischemic symptoms and significant plaque enhancement may be an important indication of its instability.