Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Gulou District, Nanjing, 210009, Jiangsu Province, China.
Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Gulou District, Nanjing, 210009, Jiangsu Province, China.
Clin Radiol. 2023 May;78(5):e442-e450. doi: 10.1016/j.crad.2023.01.004. Epub 2023 Jan 31.
To investigate the association between intracranial plaque characteristics and high-sensitivity C-reactive protein (hs-CRP) levels, and their combined effects on the occurrence of acute cerebral infarction (ACI).
One hundred and forty-three patients with recent ischaemic events in the territory of middle cerebral artery or basilar artery were enrolled and divided into the ACI group (n=93) and non-ACI group (n=50) according to clinical data and diffusion-weighting imaging (DWI) results. All recruited patients underwent high-resolution magnetic resonance imaging (MRI) to assess intracranial plaque characteristics, including plaque enhancement, standardised wall index, stenosis ratio, T1 hyperintense component, remodelling pattern, plaque area, plaque burden, and maximum wall thickness. hs-CRP levels were further grouped into the low group (<1 mg/l), the intermediate group (1-3 mg/l), and the high group (≥3 mg/l). Multivariate logistic regression and receiver operating characteristic curve were constructed to evaluate the association between intracranial plaque characteristics and hs-CRP levels, as well as their synergistic effects on determining the occurrence of ACI.
High hs-CRP levels were associated with strong plaque enhancement (p<0.001, odds ratio [OR] = 7.497). Strong plaque enhancement (p=0.002, OR=2.109) and high hs-CRP levels (p=0.009, OR=3.893) were independently associated with the occurrence of ACI after adjustments for sex, age, and other traditional atherosclerotic risk factors. The combination of hs-CRP levels and strong plaque enhancement provided incremental information to determine ACI with an AUC of 0.823, which was significantly higher than that of strong plaque enhancement (0.711) and hs-CRP levels (0.686), respectively.
High hs-CRP levels were associated with strong plaque enhancement. The synergistic effects of hs-CRP levels and strong plaque enhancement provided incremental effects on the occurrence of ACI.
探讨颅内斑块特征与高敏 C 反应蛋白（hs-CRP）水平之间的关系，以及它们对急性脑梗死（ACI）发生的联合影响。
共纳入 143 例大脑中动脉或基底动脉区域近期发生缺血事件的患者，根据临床资料和弥散加权成像（DWI）结果分为 ACI 组（n=93）和非 ACI 组（n=50）。所有入选患者均行高分辨率磁共振成像（MRI）检查评估颅内斑块特征，包括斑块强化、标准化管壁指数、狭窄比、T1 高信号成分、重构模式、斑块面积、斑块负荷和最大管壁厚度。hs-CRP 水平进一步分为低水平组（<1mg/L）、中水平组（1-3mg/L）和高水平组（≥3mg/L）。采用多变量逻辑回归和受试者工作特征曲线评估颅内斑块特征与 hs-CRP 水平之间的关系，以及它们对确定 ACI 发生的协同作用。
高 hs-CRP 水平与强斑块强化相关（p<0.001，优势比[OR] = 7.497）。强斑块强化（p=0.002，OR=2.109）和高 hs-CRP 水平（p=0.009，OR=3.893）在调整性别、年龄和其他传统动脉粥样硬化危险因素后与 ACI 的发生独立相关。hs-CRP 水平与强斑块强化的联合提供了确定 ACI 的增量信息，AUC 为 0.823，明显高于强斑块强化（0.711）和 hs-CRP 水平（0.686）。
高 hs-CRP 水平与强斑块强化相关。hs-CRP 水平与强斑块强化的协同作用对 ACI 的发生具有增量效应。
