Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Neurol Res. 2021 Dec;43(12):1040-1049. doi: 10.1080/01616412.2021.1949682. Epub 2021 Jul 6.
: Gadolinium enhancement on high resolution magnetic resonance imaging (HR-MRI) has been considered a sign of instability and inflammation of intracranial atherosclerotic plaques. Our research objective was to explore the relationship between the extent of plaque enhancement (PE), the degree of intracranial artery stenosis, and acute ischemic stroke events. HR-MRI was performed in 91 patients with intracranial vascular stenosis to determine the existence and intensity of PE. Among 91 patients enrolled in the trial, there were 43 patients in the acute/subacute group (≤1 month from ischemic stroke event), 15 patients in the chronic group (>1 month from ischemic stroke event), and 33 patients in the non-culprit plaques group (no ischemic stroke event). A total of 105 intracranial atherosclerotic plaques were detected in 91 patients. 14 (13.3%) were mild-stenosis plaques, 22 (21.0%) were moderate-stenosis plaques, and 69 (65.7%) were severe-stenosis plaques. There were 12 (11.4%), 18 (17.1%), and 75 (71.4%) plaques in the non-enhanced plaque group, the mild-enhancement group, and the significant-enhancement group, respectively. The degree of PE among the acute/subacute group, the chronic group, and the non-culprit plaque group had a significant difference (P = 0.005). Enhanced plaques were more often observed in culprit plaques (acute/subacute group and chronic group) than non-culprit plaques (96.7% vs 77.3%). Non-enhanced plaques were more often observed in non-culprit plaques than culprit plaques (acute/subacute group and chronic group) (22.7% vs 3.3%). And 36.6% of the enhanced plaques were non-culprit plaques. After performing univariate and multivariate logistic regression analysis, the results showed that strong plaque enhancement (P = 0.025, odds ratio [OR] 3.700, 95% confidence interval [95% CI] 1.182-11.583) and severe stenosis (P = 0.008, OR 4.393, 95%CI 1.481-13.030) were significantly associated with acute ischemic events. Enhanced plaques were more often observed in culprit plaques, and non-enhanced plaques were more often observed in non-culprit plaques. Moreover, significant plaque enhancement and severe ICAS were closely associated with acute ischemic events.
磁共振高分辨率成像（HR-MRI）上的钆增强被认为是颅内动脉粥样硬化斑块不稳定和炎症的标志。我们的研究目的是探讨斑块增强（PE）程度、颅内动脉狭窄程度与急性缺血性卒中事件之间的关系。对 91 例颅内血管狭窄患者进行 HR-MRI 以确定 PE 的存在和强度。在纳入研究的 91 例患者中，43 例为急性/亚急性组（缺血性卒中事件发生后≤1 个月），15 例为慢性组（缺血性卒中事件发生后>1 个月），33 例为非罪犯斑块组（无缺血性卒中事件）。91 例患者共检出 105 个颅内动脉粥样硬化斑块，轻度狭窄斑块 14 个（13.3%），中度狭窄斑块 22 个（21.0%），重度狭窄斑块 69 个（65.7%）。无强化斑块组、轻度强化斑块组和显著强化斑块组分别有 12 个（11.4%）、18 个（17.1%）和 75 个（71.4%）斑块。急性/亚急性组、慢性组和非罪犯斑块组之间的 PE 程度差异有统计学意义（P=0.005）。罪犯斑块（急性/亚急性组和慢性组）中增强斑块更为常见（96.7%比 77.3%），而非罪犯斑块（急性/亚急性组和慢性组）中无强化斑块更为常见（22.7%比 3.3%）。增强斑块中有 36.6%为非罪犯斑块。单因素和多因素 logistic 回归分析结果显示，强斑块强化（P=0.025，比值比[OR]3.700，95%置信区间[95%CI]1.182-11.583）和重度狭窄（P=0.008，OR 4.393，95%CI 1.481-13.030）与急性缺血事件显著相关。罪犯斑块中更常出现增强斑块，而非罪犯斑块中更常出现无强化斑块。此外，显著斑块强化和严重颅内动脉粥样硬化与急性缺血事件密切相关。
