Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Front Immunol. 2022 Jul 22;13:915126. doi: 10.3389/fimmu.2022.915126. eCollection 2022.
Gadolinium enhancement on high-resolution vessel wall imaging (HR-VWI) is an imaging marker of intracranial atherosclerotic stenosis (ICAS) plaque instability. This study aimed to evaluate the relationships between hematological inflammatory indicators and the enhancement of ICAS plaques and to search for hematological indicators that can predict ICAS plaque instability.
Consecutive adult patients diagnosed with ICAS from April 2018 to December 2021 were recruited retrospectively, and every patient underwent HR-VWI. Plaque enhancement was measured qualitatively and quantitatively. The plaque-to-pituitary stalk contrast ratio (CR) indicated the degree of plaque enhancement. Clinical and laboratory data, including the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII), were recorded. The hematological inflammatory indicators were compared between ICAS patients with and without plaque enhancement and between patients with and without symptomatic plaque. The hematological inflammatory indicators and the CR were compared using linear regression. Furthermore, receiver operating characteristic curve analysis was performed to assess the discriminative abilities of the inflammatory indicators to predict plaque instability.
Fifty-nine patients were included. The NLR, SII and LMR were significantly correlated with plaque enhancement. The LMR was independently associated with plaque enhancement, and a linear negative correlation was observed between the LMR and CR (R = 0.716, < 0.001). The NLR, LMR, plaque enhancement and CR were significantly associated with symptomatic ICAS, and the LMR and plaque enhancement were independent risk factors for symptomatic ICAS. The optimal cutoff value of the admission LMR to distinguish symptomatic plaque from asymptomatic plaque was 4.0 (80.0% sensitivity and 70.6% specificity).
The LMR was independently associated with ICAS plaque enhancement and showed a linear negative correlation with CR. The LMR and plaque enhancement were independent risk factors for symptomatic ICAS. An LMR ≤ 4.0 may predict ICAS plaque instability.
高分辨率血管壁成像（HR-VWI）上的钆增强是颅内动脉粥样硬化性狭窄（ICAS）斑块不稳定的影像学标志物。本研究旨在评估血液炎症指标与 ICAS 斑块增强之间的关系，并寻找可预测 ICAS 斑块不稳定的血液学指标。
回顾性招募了 2018 年 4 月至 2021 年 12 月连续诊断为 ICAS 的成年患者，并对每位患者进行 HR-VWI。对斑块增强进行定性和定量测量。斑块与垂体柄对比度比（CR）表示斑块增强的程度。记录临床和实验室数据，包括淋巴细胞单核细胞比值（LMR）、中性粒细胞淋巴细胞比值（NLR）和全身免疫炎症指数（SII）。比较有和无斑块增强以及有和无症状斑块的 ICAS 患者之间的血液炎症指标。使用线性回归比较炎症指标与 CR。此外，还进行了受试者工作特征曲线分析，以评估炎症指标预测斑块不稳定的鉴别能力。
共纳入 59 例患者。NLR、SII 和 LMR 与斑块增强显著相关。LMR 与斑块增强独立相关，LMR 与 CR 呈线性负相关（R=0.716，<0.001）。NLR、LMR、斑块增强和 CR 与症状性 ICAS 显著相关，LMR 和斑块增强是症状性 ICAS 的独立危险因素。入院时 LMR 区分有症状和无症状斑块的最佳截断值为 4.0（80.0%敏感性和 70.6%特异性）。
LMR 与 ICAS 斑块增强独立相关，与 CR 呈线性负相关。LMR 和斑块增强是症状性 ICAS 的独立危险因素。LMR≤4.0 可能预测 ICAS 斑块不稳定。
