Value of multiparameter MRI in predicting acute cerebral infarction secondary to transient ischemic attack / 中华神经医学杂志

ABSTRACT

Objective:To investigate the value of multiparameter MRI in predicting secondary acute cerebral infarction in patients with transient ischemic attack (TIA).Methods:A total of 358 patients with TIA admitted to Department of Neurology, Affiliated Hospital of Chengde Medical College from April 2020 to May 2022 were selected. They were divided into cerebral infarction group ( n=114) and non-cerebral infarction group ( n=244) according to whether they had secondary acute cerebral infarction within 3 months of follow up. Differences in multiparameter MRI (number of unstable plaques, reference vessel area/plaque area, internal carotid artery stenosis rate, intracranial arterial stenosis rate, ratio of unstable plaques, lumen area of the most stenotic responsible vessel, and wall area of the most stenotic responsible vessel) at the consultation time were collected and compared between the 2 groups; correlations of multiparameter MRI with secondary acute cerebral infarction was evaluated by partial regression analysis; value of multiparameter MRI in predicting secondary acute cerebral infarction in TIA patients was evaluated by receiver operating characteristic (ROC) curve. Results:Reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques and wall area of the most stenotic responsible vessel in the infarction group were significantly higher/larger than those in the non-cerebral infarction group, and lumen area of the most stenotic responsible vessel in the infarction group was significantly smaller than that in the non-cerebral infarction group ( P<0.05). After adjusting for age and gender, reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques and wall area of the most stenotic responsible vessel were positively correlated with secondary acute cerebral infarction, while lumen area of the most stenotic responsible vessel was negatively correlated with secondary acute cerebral infarction ( P<0.05); AUC of the combination of above parameters was 0.900, which was significantly greater than that of reference vessel area/plaque area (0.724), intracranial arterial stenosis rate (0.751), unstable plaque occurrence rate (0.812), lumen area of the most stenotic vessel (0.771), and wall area of the most stenotic vessel (0.763), respectively ( P<0.05). Conclusion:Multiparameter MRI analyzing reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques, lumen area of the most stenotic responsible vessel, and wall area of the most stenotic responsible vessel can effectively predict secondary acute cerebral infarction in TIA patients.