Lee Chae Rin, Yang Jun Cheol, Lee Ui Yun, Hwang Seung Bae, Chung Gyung Ho, Kwak Hyo Sung
Medical School, Jeonbuk National University, Jeon-ju 54907, Korea.
Division of Mechanical Design Engineering, College of Engineering, Jeonbuk National University, Jeon-ju 54896, Korea.
Diagnostics (Basel). 2022 Sep 26;12(10):2321. doi: 10.3390/diagnostics12102321.
Background: To determine the prevalence of symptomatic nonstenotic carotid disease (SyNC) using simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) imaging for patients with acute stroke as an MR screen protocol and to assess imaging findings of carotid plaques. Patients and Methods: From May 2020 to October 2021, 2459 patients with suspected acute neurological symptoms were evaluated with brain diffusion-weighted imaging (DWI) and carotid SNAP imaging. We analyzed the degree of stenosis and intraplaque hemorrhage (IPH) using SNAP imaging. Prevalence of SyNC and risk factors for stroke in patients with SyNC were determined. We performed subgroup multivariate analysis between SyNC and other etiologies of stroke (non-SyNC). Results: Of 4608 carotid arteries in 2304 patients enrolled in this study, 454 (9.9%) plaques (both lesions in 128 patients) were found on SNAP imaging. Of these plaques, 353 (77.8%) showed stenosis of <50%. Of plaques with <50% stenosis, 47 (13.3%) patients had a territorial acute focal infarction. Seventeen (36.2%) were classified with embolic stroke of undetermined source (ESUS) and SyNC. High maximal wall thickness and carotid IPH were identified as influencing factors for SyNC. Conclusion: For patients with <50% stenosis and territorial infarction, SyNC is a relatively important source of stroke. Especially, high maximal wall thickness and carotid IPH are important risk factors for SyNC.
采用同时进行的非对比血管造影和斑块内出血（SNAP）成像作为磁共振筛查方案，以确定急性卒中患者中症状性非狭窄性颈动脉疾病（SyNC）的患病率，并评估颈动脉斑块的影像学表现。患者与方法：2020年5月至2021年10月，对2459例疑似急性神经症状患者进行脑扩散加权成像（DWI）和颈动脉SNAP成像评估。我们使用SNAP成像分析狭窄程度和斑块内出血（IPH）情况。确定SyNC的患病率以及SyNC患者的卒中危险因素。我们对SyNC与其他卒中病因（非SyNC）进行亚组多变量分析。结果：在本研究纳入的2304例患者的4608条颈动脉中，SNAP成像发现454个（9.9%）斑块（128例患者存在两处病变）。在这些斑块中，353个（77.8%）显示狭窄程度<50%。在狭窄程度<50%的斑块中，47例（13.3%）患者发生了区域性急性局灶性梗死。17例（36.2%）被归类为不明来源栓塞性卒中（ESUS）和SyNC。最大管壁厚度和颈动脉IPH被确定为SyNC的影响因素。结论：对于狭窄程度<50%且发生区域性梗死的患者，SyNC是卒中的一个相对重要来源。特别是，最大管壁厚度和颈动脉IPH是SyNC的重要危险因素。
