PDF(Pubmed)
Abstract：
UNASSIGNED: One of the widespread manifestations of cerebral small vessel disease (CSVD) of the brain parenchyma is white matter lesion, which appears as white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). Previous studies have illustrated that large artery atherosclerosis is related to CSVD, but the precise progress of pathogenesis remains unknown. High-resolution MRI (HR-MRI) has the ability to delineate intracranial vascular walls, enabling a thorough exploration of the structure and composition of unstable plaques. This study aimed to apply HR-MRI to characterize the wall changes and plaque characteristics of middle cerebral arteries in patients with WMHs and to investigate the correlation between plaque vulnerability parameters and different degrees of WMHs.
UNASSIGNED: In this study, 138 patients with acute ischemic stroke at Harbin Medical University\'s First Clinical Hospital (May 2021 to October 2023) were cross-sectionally reviewed and underwent conventional brain and HR-MRI using T1-weighted 3D volumetric isotropic turbo spin echo acquisition (T1W-3D-VISTA) of the unilateral middle cerebral artery (MCA). According to Fazekas grade (0-6), the patients were divided into two groups: Fazekas score 0-2, no-or-mild WMHs; and Fazekas 3-6, moderate-to-severe WMHs. The intraplaque hemorrhage, plaque distribution, plaque enhancement, plaque load, remodeling pattern, and stenosis of the two groups were measured. Binary logistic regression analysis was conducted to evaluate the relationship between vulnerable plaques and WMHs.
UNASSIGNED: Of the participants who were initially considered for inclusion, 71 were deemed eligible, among whom 34 were placed in the no-or-mild WMH group and 37 in the moderate-to-severe WMH group. Between the two groups, there were significant differences in intraplaque hemorrhage (P=0.01), a wide distribution (P=0.02), and plaque enhancement (P=0.02). Univariate analysis showed that WMHs were associated with age [odds ratio (OR) =1.080; 95% confidence interval (CI): 1.020-1.144; P=0.008], hypertension (OR =3.500; 95% CI: 1.276-9.597; P=0.01), intraplaque hemorrhage (OR =3.955; 95% CI: 1.247-12.538; P=0.02), a wide distribution (OR =3.067; 95% CI: 1.159-8.115; P=0.02), and significant plaque enhancement (OR =4.372; 95% CI: 1.101-17.358; P=0.03); however, the multivariate results showed that the only independent factors associated with WMHs were age (OR =1.095; 95% CI: 1.019-1.176; P=0.01) and intraplaque hemorrhage (OR =5.88; 95% CI: 1.466-23.592; P=0.01).
UNASSIGNED: Our findings suggest that age and intraplaque hemorrhage may be associated with more severe WMHs in patients with acute ischemic stroke, which may be helpful for further clinical examination and intervention treatment.
UNASSIGNED: In this study, 138 patients with acute ischemic stroke at Harbin Medical University\'s First Clinical Hospital (May 2021 to October 2023) were cross-sectionally reviewed and underwent conventional brain and HR-MRI using T1-weighted 3D volumetric isotropic turbo spin echo acquisition (T1W-3D-VISTA) of the unilateral middle cerebral artery (MCA). According to Fazekas grade (0-6), the patients were divided into two groups: Fazekas score 0-2, no-or-mild WMHs; and Fazekas 3-6, moderate-to-severe WMHs. The intraplaque hemorrhage, plaque distribution, plaque enhancement, plaque load, remodeling pattern, and stenosis of the two groups were measured. Binary logistic regression analysis was conducted to evaluate the relationship between vulnerable plaques and WMHs.
UNASSIGNED: Of the participants who were initially considered for inclusion, 71 were deemed eligible, among whom 34 were placed in the no-or-mild WMH group and 37 in the moderate-to-severe WMH group. Between the two groups, there were significant differences in intraplaque hemorrhage (P=0.01), a wide distribution (P=0.02), and plaque enhancement (P=0.02). Univariate analysis showed that WMHs were associated with age [odds ratio (OR) =1.080; 95% confidence interval (CI): 1.020-1.144; P=0.008], hypertension (OR =3.500; 95% CI: 1.276-9.597; P=0.01), intraplaque hemorrhage (OR =3.955; 95% CI: 1.247-12.538; P=0.02), a wide distribution (OR =3.067; 95% CI: 1.159-8.115; P=0.02), and significant plaque enhancement (OR =4.372; 95% CI: 1.101-17.358; P=0.03); however, the multivariate results showed that the only independent factors associated with WMHs were age (OR =1.095; 95% CI: 1.019-1.176; P=0.01) and intraplaque hemorrhage (OR =5.88; 95% CI: 1.466-23.592; P=0.01).
UNASSIGNED: Our findings suggest that age and intraplaque hemorrhage may be associated with more severe WMHs in patients with acute ischemic stroke, which may be helpful for further clinical examination and intervention treatment.
摘要：
■脑实质的脑小血管病（CSVD）的广泛表现之一是白质病变，在磁共振成像（MRI）上表现为白质高强度（WMHs）。以往的研究表明，大动脉粥样硬化与CSVD有关，但是发病机制的确切进展仍然未知。高分辨率MRI（HR-MRI）具有描绘颅内血管壁的能力，能够彻底探索不稳定斑块的结构和组成。本研究旨在应用HR-MRI表征WMHs患者大脑中动脉的壁改变和斑块特征，并探讨斑块易损性参数与不同程度WMHs的相关性。
■在这项研究中，在哈尔滨医科大学第一临床医院（2021年5月至2023年10月）对138例急性缺血性卒中患者进行了横断面检查，并使用T1加权3D体积各向同性涡轮自旋回波采集（T1W-3D-VISTA）对单侧大脑中动脉（MCA）进行了常规脑部和HR-MRI检查。根据Fazekas等级（0-6），患者分为两组:Fazekas评分0-2,无或轻度WMHs;和Fazekas3-6,中度至重度WMHs.斑块内出血，斑块分布，斑块增强,斑块负荷，重塑模式，测量两组的狭窄程度。采用二元Logistic回归分析评价易损斑块与WMHs的关系。
■在最初考虑纳入的参与者中，71人被认为是合格的，其中34人属于非或轻度WMH组,37人属于中重度WMH组.在两组之间，斑块内出血差异有统计学意义(P=0.01),分布广泛(P=0.02)，和斑块增强（P=0.02）。单因素分析显示WMHs与年龄相关[比值比(OR)=1.080;95%置信区间(CI):1.020-1.144;P=0.008],高血压(OR=3.500;95%CI:1.276-9.597;P=0.01),斑块内出血(OR=3.955;95%CI:1.247-12.538;P=0.02),分布广泛(OR=3.067；95%CI：1.159-8.115；P=0.02)，和显著的斑块增强(OR=4.372;95%CI:1.101-17.358;P=0.03);多变量结果显示,与WMHs相关的独立因素是年龄(OR=1.095;95%CI:1.019-1.176;P=0.01)和斑块内出血(OR=5.88;95%CI:1.466-23.592;P=0.01).
■我们的研究结果表明，年龄和斑块内出血可能与急性缺血性卒中患者更严重的WMHs相关，这可能有助于进一步的临床检查和干预治疗。
■在这项研究中，在哈尔滨医科大学第一临床医院（2021年5月至2023年10月）对138例急性缺血性卒中患者进行了横断面检查，并使用T1加权3D体积各向同性涡轮自旋回波采集（T1W-3D-VISTA）对单侧大脑中动脉（MCA）进行了常规脑部和HR-MRI检查。根据Fazekas等级（0-6），患者分为两组:Fazekas评分0-2,无或轻度WMHs;和Fazekas3-6,中度至重度WMHs.斑块内出血，斑块分布，斑块增强,斑块负荷，重塑模式，测量两组的狭窄程度。采用二元Logistic回归分析评价易损斑块与WMHs的关系。
■在最初考虑纳入的参与者中，71人被认为是合格的，其中34人属于非或轻度WMH组,37人属于中重度WMH组.在两组之间，斑块内出血差异有统计学意义(P=0.01),分布广泛(P=0.02)，和斑块增强（P=0.02）。单因素分析显示WMHs与年龄相关[比值比(OR)=1.080;95%置信区间(CI):1.020-1.144;P=0.008],高血压(OR=3.500;95%CI:1.276-9.597;P=0.01),斑块内出血(OR=3.955;95%CI:1.247-12.538;P=0.02),分布广泛(OR=3.067；95%CI：1.159-8.115；P=0.02)，和显著的斑块增强(OR=4.372;95%CI:1.101-17.358;P=0.03);多变量结果显示,与WMHs相关的独立因素是年龄(OR=1.095;95%CI:1.019-1.176;P=0.01)和斑块内出血(OR=5.88;95%CI:1.466-23.592;P=0.01).
■我们的研究结果表明，年龄和斑块内出血可能与急性缺血性卒中患者更严重的WMHs相关，这可能有助于进一步的临床检查和干预治疗。
