Assessing the characteristics and diagnostic value of plaques for patients with acute stroke using high-resolution magnetic resonance imaging

Quantitative Imaging in Medicine and Surgery

article

Danfeng Zhang¹  Mi Wang¹  Lili Wu²  Ying Zhao¹  Siyu Wang¹  Xindao Yin¹  Xinying Wu¹ 

[1] Department of Radiology, Nanjing First Hospital , Nanjing Medical University;Kangda College of Nanjing Medical University

关键词: Magnetic resonance imaging;    middle cerebral artery (MCA);    atherosclerosis;    vascular remodelling;   

DOI  :  10.21037/qims-21-531

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: A comprehensive understanding of atherosclerotic plaques aids physicians in evaluation and treatment of stroke. This study set out to evaluate the characteristics and diagnostic value of atherosclerotic plaques in patients with acute stroke and stenotic middle cerebral artery (MCA) using high-resolution magnetic resonance imaging. Methods: Sixty-five consecutive patients with transient ischemic attack or recent ischemic stroke were prospectively recruited. All enrolled patients underwent routine magnetic resonance scans and cross-sectional scans of the stenotic MCA vascular wall. Differences in vascular wall parameters and location, the enhancement degree, and remodelling patterns of plaques in the stenotic MCA were compared between symptomatic (n=30) and asymptomatic (n=35) groups of patients. The statistically significant indicators were then subjected to logistic regression analysis to identify which factors could better predict acute stroke. Results: Compared with the asymptomatic group, the symptomatic group had a smaller lumen area (LA) (P=0.027), larger plaque area (P<0.001), larger remodelling index (P<0.001), more superior/posterior plaques (P=0.001), more obviously enhanced plaques (P<0.001), and a greater number of PR patterns (P<0.001) in the stenotic MCA. Logistic regression analysis showed that the plaque area, remodelling patterns, LA in the stenotic MCA, enhancement degree, and plaque location were predictors of acute stroke. The combination of the plaque area and LA in the stenotic MCA, and the plaque enhancement degree had optimal predictive value (area under the curve =0.927). Conclusions: A larger plaque area and smaller LA in the stenotic MCA, and obvious plaque enhancement might indicate that a patient is prone to acute stroke.

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