Back to Search Start Over

Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study.

Authors :
Yuan, Weizhuang
Liu, Xiaoyun
Yan, Zhongrui
Wu, Bo
Lu, Baoquan
Chen, Beilei
Tian, Daishi
Du, Ailian
Li, Litao
Liu, Changyun
Liu, Guangzhi
Gong, Tao
Shi, Zhimin
Feng, Feng
Liu, Caiyan
Meng, Yao
Lin, Qianqian
Li, Mingli
Xu, Wei-Hai
Source :
International Journal of Stroke; Jun2024, Vol. 19 Issue 5, p569-576, 8p
Publication Year :
2024

Abstract

Background: High-resolution magnetic resonance vessel wall imaging (HRMR-VWI) is a promising technique for identifying intracranial vulnerable plaques beyond lumen narrowing. However, the association between HRMR-VWI characteristics and recurrent stroke remains uncertain. Aims: This study aimed to investigate the association between HRMR-VWI characteristics and recurrent ipsilateral stroke in patients with symptomatic intracranial atherosclerotic steno-occlusive disease (ICAS). Methods: This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. Participants were assessed by multiparametric magnetic resonance imaging (MRI) including diffusion-weighted imaging, three-dimension time-of-flight magnetic resonance angiography, and three-dimensional T1-weighted HRMR-VWI. The patients were recommended to receive best medical therapy and were systematically followed up for 12 months. The association between HRMR-VWI characteristics and the time to recurrent ipsilateral stroke was investigated by univariable and multivariable analysis. Results: Two hundred and fifty-five consecutive patients were enrolled from 15 centers. The cumulative 12 month ipsilateral recurrence incidence was 4.1% (95% confidence interval (CI): 1.6–6.6%). Patients with recurrent ipsilateral stroke exhibited higher rates of intraplaque hemorrhage (IPH) (30.0% vs 6.5%) and eccentric plaque (90.0% vs 48.2%), and lower occurrence of occlusive thrombus (10.0% vs 23.7%). Plaque length (5.69 ± 2.21 mm vs 6.67 ± 4.16 mm), plaque burden (78.40 ± 7.37% vs 78.22 ± 8.32%), degree of stenosis (60.25 ± 18.95% vs 67.50% ± 22.09%) and remodeling index (1.07 ± 0.27 vs 1.03 ± 0.35) on HRMR-VWI did not differ between patients with and without recurrent ipsilateral stroke. In the multivariable Cox regression analysis, IPH (hazard ratio: 6.64, 95% CI: 1.23–35.8, p = 0.028) was significantly associated with recurrent ipsilateral stroke after adjustment. Conclusions: Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies. Data access statement: Data from this study are available and can be accessed upon request. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17474930
Volume :
19
Issue :
5
Database :
Complementary Index
Journal :
International Journal of Stroke
Publication Type :
Academic Journal
Accession number :
177534148
Full Text :
https://doi.org/10.1177/17474930241228203