Abstract:

Objective To investigate whether there are differences in characteristics of intracranial atherosclerotic plaque of different mechanisms of patients with intracranial atherosclerotic stroke. Methods Patients who were diagnosed with symptomatic intracranial atherosclerotic stenosis (sICAS) according to Chinese Ischemic Stroke Subclassification (CISS) criteria were recruited consecutively as study subject into this study. Patients whose diagnosis was asymptomatic intracranial atherosclerotic disease were enrolled as control group. All subjects underwent 3-T high-resolution magnetic resonance imaging (HR MRI) in the relevant intracranial artery. The characteristics of intracranial atherosclerotic plaque in different mechanisms of intracranial atherosclerotic stroke were compared. Results Finally, 56 sICAS patients and non-symptomatic ICAS patients were enrolled into study. Compared with non-symptomatic ICAS patients, the manifestation of characteristics of intracranial atherosclerotic plaque of sICAS patients including high rate of outward remodeling of the stenotic area and low rate of inward remodeling of the stenotic area, and the plaques of the symptomatic group were more frequently located close to perforator arterial openings. There was no significant difference in the characteristics of intracranial atherosclerotic plaque in different mechanisms of intracranial atherosclerotic stroke. HR MRI found atherosclerotic plaque in 10 patients who hadn’t been identified with intracranial artery stenosis by transcranial Doppler (TCD) and magnetic resonance angiography (MRA).Conclusion HR MRI is helpful in discovering the existence of atherosclerotic plaques in sICAS patients, however, there is no significant difference in HR MRI characteristic of intracranial atherosclerotic plaque of different mechanisms of sICAS.

Key words: High resolution magnetic resonance imaging; Intracranial artery atherosclerosis; Plaque; Stroke classi?cation

摘要：

目的 探究不同机制大动脉粥样硬化型卒中患者颅内动脉粥样硬化斑块的特征是否存在差别。 方法 依据中国缺血性卒中亚型（Chinese Ischemic Stroke Subclassification，CISS）分型标准连续收录症 状性颅内动脉粥样硬化性疾病（symptomatic intracranial atherosclerotic stenosis，sICAS）患者作为研究 对象，并依据梗死机制将sICAS患者分组，无症状性ICAS患者作为对照组。对所有入组患者的责任动 脉管壁行高分辨率磁共振（high-resolution magnetic resonance imaging，HR MRI）扫描，比较不同机制 sICAS患者动脉粥样硬化斑块的特征。 结果 共有56例sICAS患者、9例无症状性ICAS患者纳入本研究。与无症状性ICAS患者比较，sICAS患者 颅内动脉粥样硬化斑块的特征表现为：病变局部正性重构率高、负性重构率低；动脉粥样硬化斑块 更多位于穿支动脉开口处。但不同机制sICAS患者颅内动脉粥样硬化斑块特征未发现明显差别。入组 患者中10例经经颅多普勒（transcranial Doppler，TCD）/磁共振血管成像（magnetic resonance angiography， MRA）检查未发现颅内动脉狭窄，经HR MRI检查发现存在粥样硬化斑块。 结论 HR MRI有助于发现sICAS患者不稳定斑块的存在，但不同机制sICAS患者颅内动脉粥样硬化斑 块的HR MRI特征差异无显著性。

关键词: 高分辨率磁共振成像; 颅内动脉粥样硬化; 斑块; 卒中分型