Objective The aim of this study is to investigate the plaque characteristics of different subtypes of middle cerebral artery(MCA)infarction,lenticulostriate artery(LSA)characteristics,and hemodynamic characteristics through high-resolution magnetic resonance vessel wall imaging(HR-MRI VWI)and perfusion weighted imaging(PWI).Methods A retrospective analysis was conducted on patients with unilateral acute or subacute MCA infarction who underwent HR-MRI VWI and PWI examinations at Qinhuangdao First Hospital from January 2022 to April 2024.Patients were divided into three groups according to the type of infarction:artery-to-artery embolism(AA),branch occlusive disease(BOD),branch occlusive disease and artery-to-artery embolism(BOD-AA).Clinical data,plaque characteristics,lenticulostriate artery characteristics,and hemodynamic characteristics were compared and analyzed among the three groups.To determine factors associated with BOD,the BOD and BOD-AA groups were merged into a BOD+group which was then compared with the AA group.To determine factors associated with the AA group,the BOD-AA and AA groups were combined into an AA+group,followed by comparison with the BOD group.Results A total of 42 patients with unilateral acute or subacute MCA infarction were included according to the inclusion and exclusion criteria.Among them,9 patients were classified as having AA,14 patients as having BOD,and 19 as having BOD-AA.The results showed that the degree of stenosis was higher in the AA+group than in the BOD group,and the difference was statistically significant(Z=-2.536,P<0.05);The number of LSA on the affected side was higher in the BOD+group than in the AA group[2.00(1.50,3.00)vs.3.00(3.00,4.00)],and the difference was statistically significant(Z=-2.889,P<0.05);The relative cerebral blood flow(rCBF)of the centrum semiovale was lower in the AA+group than in the BOD group[0.90(0.84,0.93)vs.0.99(0.97,1.03)],and the difference was statistically significant(Z=-4.555,P<0.05);The rCBF in the basal ganglia was lower in the BOD+group than in the AA group[0.89(0.83,0.93)vs.1.01(0.98,1.04)],and the difference was statistically significant(Z=-4.280,P<0.05).Conclusion Patients in BOD+have a lower degree of stenosis compared to AA group.The spatial relationship between plaques and LSA varies across different subtypes of MCA infarction.Plaques in BOD+patients are positioned closer to the LSA orifice and thus have a higher tendency to occlude the LSA orifice.The affected side has few LSAs and the rCBF in the LSA perfusion area.is lower.

Objective The aim of this study is to investigate the plaque characteristics of different subtypes of middle cerebral artery(MCA)infarction,lenticulostriate artery(LSA)characteristics,and hemodynamic characteristics through high-resolution magnetic resonance vessel wall imaging(HR-MRI VWI)and perfusion weighted imaging(PWI).Methods A retrospective analysis was conducted on patients with unilateral acute or subacute MCA infarction who underwent HR-MRI VWI and PWI examinations at Qinhuangdao First Hospital from January 2022 to April 2024.Patients were divided into three groups according to the type of infarction:artery-to-artery embolism(AA),branch occlusive disease(BOD),branch occlusive disease and artery-to-artery embolism(BOD-AA).Clinical data,plaque characteristics,lenticulostriate artery characteristics,and hemodynamic characteristics were compared and analyzed among the three groups.To determine factors associated with BOD,the BOD and BOD-AA groups were merged into a BOD+group which was then compared with the AA group.To determine factors associated with the AA group,the BOD-AA and AA groups were combined into an AA+group,followed by comparison with the BOD group.Results A total of 42 patients with unilateral acute or subacute MCA infarction were included according to the inclusion and exclusion criteria.Among them,9 patients were classified as having AA,14 patients as having BOD,and 19 as having BOD-AA.The results showed that the degree of stenosis was higher in the AA+group than in the BOD group,and the difference was statistically significant(Z=-2.536,P<0.05);The number of LSA on the affected side was higher in the BOD+group than in the AA group[2.00(1.50,3.00)vs.3.00(3.00,4.00)],and the difference was statistically significant(Z=-2.889,P<0.05);The relative cerebral blood flow(rCBF)of the centrum semiovale was lower in the AA+group than in the BOD group[0.90(0.84,0.93)vs.0.99(0.97,1.03)],and the difference was statistically significant(Z=-4.555,P<0.05);The rCBF in the basal ganglia was lower in the BOD+group than in the AA group[0.89(0.83,0.93)vs.1.01(0.98,1.04)],and the difference was statistically significant(Z=-4.280,P<0.05).Conclusion Patients in BOD+have a lower degree of stenosis compared to AA group.The spatial relationship between plaques and LSA varies across different subtypes of MCA infarction.Plaques in BOD+patients are positioned closer to the LSA orifice and thus have a higher tendency to occlude the LSA orifice.The affected side has few LSAs and the rCBF in the LSA perfusion area.is lower.