Đặc điểm hình ảnh hẹp động mạch nội sọ trên cộng hưởng từ và mối liên quan với một số yếu tố nguy cơ, nguyên nhân của hẹp mạch máu não

Abstract

Objective: This study aims to describe the characteristics of cerebral
artery stenosis on MRI and the relationship with some risk factors and
causes of cerebral artery stenosis.
Method: Cross-sectional descriptive study from 104 patients with
images of intracranial artery stenosis using 3T MRI, from June 2021 to
June 2022 at Bach Mai hospital, Hanoi, Vietnam.
Results: The average age is 64.71 ± 14.08, the age group ≥60
accounts for the highest proportion of 76%, the male/female ratio is ~
2.58:1. 27 patients (26%) had from two or more narrowing arteries. Stenosis
is common in the anterior circulation (66.4%), the ratio posterior/anterior
circulation ~ 2:1. ICA and MCA are the most affected (33,6% & 29,3%,
respectively), ACA is the least affected (3,6%). In anterior circulation,
moderate stenosis accounts for the highest rate (33.6%; p=0.008), arterial
occlusion is relatively high in cases of stenosis in the posterior circulation
(38.2%; p= 0.409). Eccentric stenosis is the highest (79/140; 56.4%),
followed by occlusion (39/140, 27.8%), concentric stenosis (22/140;
15.8%) (p =0.135). Among risk factors, arterial hypertension increases the
rate of stenosis by 2,840 times (p = 0.031, 95% CI [1,099;7,340]) and the
rate of atherosclerosis by 3,102 times (p = 0.012), 95% CI [1.254;7.675]).
Atherosclerosis is the main cause of arterial stenosis and occlusion
(0.52%); followed by the undetermined cause (19.3%), vasospasm (15%),
and MoyaMoya (5.7%). Brain parenchymal damage has the highest rate in
stenosis and occlusion due to atherosclerosis (74%, p < 0.05).
Conclusion: Cerebral vascular stenosis is common in the anterior
circulation, mainly in the ICA and MCA. Atherosclerosis is a common cause
of cerebral artery stenosis in both the anterior and posterior circulation.
Arterial hypertension is a risk factor for cerebral artery stenosis.