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Edge-Type Hyperintense Intracranial Artery Plaque: A Potential MRI Biomarker of Stroke Recurrence.
Li, Hongxia; Chen, Sui; Liu, Jia; Li, Yingle; Zhou, Changsheng; Guo, Bangjun; Tang, Chunxiang; Liu, Quanhui; Zhi, Beibei; Zhang, Longjiang; Zhang, Zhiqiang; Cheng, Xiaoqing; Lu, Guangming.
Affiliation
  • Li H; Department of Medical Imaging, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.
  • Chen S; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Liu J; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Li Y; Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.
  • Zhou C; Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.
  • Guo B; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Tang C; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Liu Q; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Zhi B; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Zhang L; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Zhang Z; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Cheng X; Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
  • Lu G; Department of Medical Imaging, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China.
J Magn Reson Imaging ; 60(5): 2030-2039, 2024 Nov.
Article in En | MEDLINE | ID: mdl-38243667
ABSTRACT

BACKGROUND:

Identifying patients at high risk of stroke recurrence is important for stroke prevention and treatment.

PURPOSE:

To explore the characteristics of T1 hyperintense plaques (HIP) and their relationship with stroke recurrence in patients with symptomatic intracranial atherosclerotic stenosis (sICAS). STUDY TYPE Retrospective. POPULATION One hundred fifty-seven patients with moderate-to-severe (≥50%) nonocclusive sICAS and MRI studies (42 females and 115 males, mean age 58.69 ± 10.68 years). FIELD STRENGTH/SEQUENCE 3D higher-resolution black-blood T1-weighted fast-spin-echo sequence at 3.0 T. ASSESSMENT HIP (signal intensity [SI] of plaque-to-adjacent gray matter >1.0 on non-contrast T1-weighted images) and non-HIP plaques were identified. HIP plaques were categorized as edge type (high SI adjacent to lumen) and non-edge type (high SI within plaque). Clinical and imaging features of different plaque types were compared. Stroke recurrence was assessed through telephone or medical records at 3 and 6 months, and then once a year post-MRI. The relationship between edge type and non-edge types HIP with stroke recurrence was analyzed. STATISTICAL TESTS Student's t test, Mann-Whitney U-test, chi square test and Fisher's exact test to compare features between plaque types. Kaplan-Meier curves (with log-rank tests) and Cox proportional hazards regression to assess relationship between stroke recurrence and different plaque types. A two-tailed P-value of <0.05 was considered statistically significant.

RESULTS:

Of 157 culprit lesions, 87 (55%) were HIPs (43 edge type, 44 non-edge type) and 70 (45%) were non-HIPs. Plaque thickness, area, and volume were significantly higher for HIPs than for non-HIPs. Among patients with HIPs, edge type was significantly more likely in the posterior circulation (53.5% vs. 27.3%), and had significantly higher plaque thickness, length, area, volume, plaque burden, and remodeling index than non-edge type. Edge-type HIP was significantly more common than non-edge HIP in patients with diabetes mellitus (51.2% vs. 29.5%) and dyslipidemia (79.1% vs. 54.5%). During median follow-up of 27 months, 33 patients experienced stroke recurrence. Recurrence was associated with edge-type HIP (adjusted hazard ratio = 2.83; 95% confidence interval 1.40-5.69), both in the overall cohort (34.9% vs. 15.8%) and in patients with HIP (34.9% vs. 9.0%). Age ≥60 years and edge-type HIP had a significant interaction. DATA

CONCLUSIONS:

Hyperintense plaque may be categorized as edge type or non-edge type. Edge-type HIP may be a potential MRI biomarker of stroke recurrence. EVIDENCE LEVEL 3 TECHNICAL EFFICACY Stage 2.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Recurrence / Magnetic Resonance Imaging / Stroke / Plaque, Atherosclerotic Type of study: Prognostic_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: J Magn Reson Imaging Journal subject: DIAGNOSTICO POR IMAGEM Year: 2024 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Recurrence / Magnetic Resonance Imaging / Stroke / Plaque, Atherosclerotic Type of study: Prognostic_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: J Magn Reson Imaging Journal subject: DIAGNOSTICO POR IMAGEM Year: 2024 Document type: Article Affiliation country: Country of publication: