Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China.
Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China.
Neuroradiology. 2022 Dec;64(12):2257-2266. doi: 10.1007/s00234-022-03002-y. Epub 2022 Jun 29.
Data on evolution of intracranial plaques in acute ischemic stroke patients after receiving medical therapy is still limited. We aimed to investigate the plaque features associated with culprit lesions and to explore the plaque longitudinal changes during treatment using high-resolution vessel wall MR imaging (VW-MRI).
Twenty-three patients (16 men; mean age, 51.4 years ± 11.1) with acute ischemic stroke underwent 3-T VW-MRI for intracranial atherosclerosis and were taken follow-up assessments. Each identified plaque was retrospectively classified as culprit, probably culprit, or nonculprit. Plaque features were analyzed at both baseline and follow-up and were compared using paired t-test, paired Wilcoxon test, or McNemar's test.
A total of 87 intracranial plaques were identified (23 [26.4%] culprit, 10 [11.5%] probably culprit, and 54 [62.1%] nonculprit plaques). The median time interval between initial and follow-up MRI scans was 8.0 months. In the multiple ordinal logistic regression analysis, plaque contrast ratio (CR) (OR, 1.037; 95% CI, 1.013-1.062; P = 0.002) and surface irregularity (OR, 4.768; 95% CI, 1.064-21.349; P = 0.041) were independently associated with culprit plaques. During follow-up, plaque length, maximum thickness, normalized wall index (NWI), stenosis degree, and CR significantly decreased (all P-values < 0.05) in the culprit plaque group. The plaque NWI and CR dropped in the probably culprit plaques (P = 0.041, 0.026, respectively). In the nonculprit plaque group, only plaque NWI and stenosis degree showed significant decrement (P = 0.017, 0.037, respectively).
Follow-up VW-MRI may contribute to plaque risk stratification and may provide valuable insights into the evolution of different plaques in vivo.
接受药物治疗后急性缺血性脑卒中患者颅内斑块演变的数据仍有限。我们旨在通过高分辨率血管壁磁共振成像（VW-MRI）来研究与罪犯病变相关的斑块特征，并探讨治疗过程中的斑块纵向变化。
23 例（男 16 例；平均年龄 51.4±11.1 岁）急性缺血性脑卒中患者接受了 3T VW-MRI 颅内动脉粥样硬化检查，并进行了随访评估。每个识别出的斑块均被回顾性地分类为罪犯、可能罪犯或非罪犯。在基线和随访时分析斑块特征，并使用配对 t 检验、配对 Wilcoxon 检验或 McNemar 检验进行比较。
共发现 87 个颅内斑块（23 个[26.4%]为罪犯斑块，10 个[11.5%]为可能罪犯斑块，54 个[62.1%]为非罪犯斑块）。初始和随访 MRI 扫描之间的中位时间间隔为 8.0 个月。在多有序逻辑回归分析中，斑块对比率（CR）（OR，1.037；95%CI，1.013-1.062；P=0.002）和表面不规则性（OR，4.768；95%CI，1.064-21.349；P=0.041）与罪犯斑块独立相关。在随访期间，罪犯斑块组的斑块长度、最大厚度、标准化管壁指数（NWI）、狭窄程度和 CR 均显著降低（均 P<0.05）。在可能罪犯斑块中，斑块 NWI 和 CR 下降（P=0.041，0.026）。在非罪犯斑块组中，只有斑块 NWI 和狭窄程度有显著下降（P=0.017，0.037）。
随访 VW-MRI 可能有助于斑块危险分层，并可提供关于体内不同斑块演变的有价值的见解。
