Correlation between MRI features and CSF inflammatory factor levels in patients with infarction or TIA, assessed by...

To explore the correlation between the time course of CE-T1WI plaque and the level of CSF inflammatory factors in patients with cerebral infarction or TIA assessed by contrast-enhanced high-resolution MRI.

From August 2019 to December 2021, 136 patients with ischemic stroke-related neurological symptoms or suspected ischemic stroke in Gong'an County Hospital of Traditional Chinese Medicine were retrospectively analyzed, including 69 men and 67 women aged 45-80 years old, with an average age of 65.98±8.29. The study was divided into two groups: infarction group (patients with high DWI signal in the middle cerebral artery supply area, n=68) and TIA group (patients with ischemic neurologic symptoms but no relevant imaging findings, n=68). Patients with grade 1 or grade 2 image quality were included in the study after imaging with a 3.0T MRI device. Unenhanced MRI (T1WI and T2WI) and contrast-enhanced T1WI (CE+T1WI) plaque signals were compared between the two groups. The expression levels of TNF-α, IL-6, and IL-1β in CSF of the two groups were detected by ELISA. VA_MLN, LA_MLN, PA, stenosis rate, and reconstruction index were compared between the two groups. The SNR and CNR values on T1WI and CE+T1WI were compared. The expression levels of TNF-α, IL-6, and IL-1β detected by ELISA in cerebrospinal fluid of patients with CE-T1WI plaque enhancement were compared.

The expression levels of TNF-α, IL-6, and IL-1β in the cerebral infarction group were higher than those in the TIA group (P<0.05). Comparing the VA_MLN, LA_MLN, PA, stenosis rate and remodeling index of the two groups, the VA_MLN, PA, and remodeling index of the cerebral infarction group were higher than in the TIA group (P>0.05), and there was no significant difference in VA_MLN and stenosis rate between groups (P<0.05). Comparing the plaque SNR and CNR values on T1WI and CE+T1WI, the signal intensity, adjacent signal intensity, SNR, and CNR of carotid plaque on CE+T1WI were higher than those on T1WI (P>0.05). The expression levels of TNF-α, IL-6, and IL-1β in the moderate enhancement group were higher than those in the non-enhancement group, and the expression levels of TNF-α, IL-6 and IL-1β in the high enhancement group were higher than those in the moderate enhancement group (P<0.05).

The temporal variation of CE-T1WI plaque was positively correlated with the level of cerebrospinal fluid inflammatory factors. High levels of inflammatory factors, positive remodeling, and significant enhancement were closely related to unstable plaque, which may increase the risk of stroke in patients with atherosclerosis.