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.
Brain Behav. 2023 Jun;13(6):e3032. doi: 10.1002/brb3.3032. Epub 2023 May 1.
Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke (IS), and high-resolution vessel wall imaging (HR-VWI) can be used to assess the plaque characteristics of ICAS. This study aimed to qualitatively and quantitatively assess plaque enhancement of ICAS and to investigate the relationship between plaque enhancement, plaque morphological features, and IS.
Data from adult patients with ICAS from April 2018 to July 2022 were retrospectively collected, and all patients underwent HR-VWI examination. Plaque enhancement was qualitatively and quantitatively assessed, and the plaque-to-pituitary stalk contrast ratio (CR) indicated the degree of plaque enhancement. Plaque characteristics, such as plaque burden and area, were quantitatively measured using HR-VWI. Furthermore, receiver-operating characteristic (ROC) analysis was performed to assess the ability of CR to discriminate plaque enhancement. The patients were divided into a symptomatic ICAS group and an asymptomatic ICAS group according to the clinical and imaging characteristics. Univariate and multivariate analyses were performed to investigate which factors were significantly associated with plaque enhancement and symptomatic ICAS. The plaque burden and CR were compared using linear regression.
A total of 91 patients with ICAS were enrolled in this study. ICAS plaque burden was significantly associated with plaque enhancement (p = .037), and plaque burden was linearly positively correlated with CR (R = 0.357, p = .001). ROC analysis showed that the cutoff value of CR for plaque enhancement was 0.56 (specificity of 81.8%). Both plaque enhancement and plaque burden were significantly associated with symptomatic ICAS, and only plaque enhancement was an independent risk factor after multivariate analysis.
Plaque burden was an independent risk factor for plaque enhancement and showed a linear positive correlation with CR. The cutoff value of CR for plaque enhancement was 0.56, and CR ≥ 0.56 was significantly associated with symptomatic ICAS, which was independently associated with plaque enhancement.
颅内动脉粥样硬化性狭窄（ICAS）是缺血性卒中（IS）的主要原因，高分辨率血管壁成像（HR-VWI）可用于评估 ICAS 的斑块特征。本研究旨在定性和定量评估 ICAS 斑块强化，并探讨斑块强化与斑块形态特征和 IS 的关系。
回顾性收集 2018 年 4 月至 2022 年 7 月期间患有 ICAS 的成年患者的数据，所有患者均行 HR-VWI 检查。对斑块强化进行定性和定量评估，并使用斑块与垂体柄对比比（CR）表示斑块强化程度。使用 HR-VWI 定量测量斑块特征，如斑块负担和面积。此外，进行接收者操作特征（ROC）分析以评估 CR 区分斑块强化的能力。根据临床和影像学特征将患者分为有症状性 ICAS 组和无症状性 ICAS 组。进行单变量和多变量分析，以探讨与斑块强化和有症状性 ICAS 显著相关的因素。使用线性回归比较斑块负担和 CR。
本研究共纳入 91 例 ICAS 患者。ICAS 斑块负担与斑块强化显著相关（p=0.037），斑块负担与 CR 呈线性正相关（R=0.357，p=0.001）。ROC 分析显示，CR 区分斑块强化的最佳截断值为 0.56（特异性为 81.8%）。斑块强化和斑块负担均与有症状性 ICAS 显著相关，多变量分析后仅斑块强化是独立危险因素。
斑块负担是斑块强化的独立危险因素，与 CR 呈线性正相关。CR 区分斑块强化的最佳截断值为 0.56，CR≥0.56 与有症状性 IS 显著相关，与斑块强化独立相关。
