Kang Dong-Wan, Kim Jonguk, Kim Do Yeon, Baik Sung Hyun, Jung Cheolkyu, Menon Bijoy K, Song Jae W, Han Moon-Ku, Bae Hee-Joon, Kim Beom Joon
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Front Neurol. 2025 Jun 16;16:1583857. doi: 10.3389/fneur.2025.1583857. eCollection 2025.
The temporal dynamics of the vessel wall in intracranial arterial disease (ICAD) may differ depending on the etiology. We investigated temporal changes in narrowed intracranial arteries after ischemic stroke using serial high-resolution vessel wall imaging (HR-VWI).
We retrospectively recruited patients with ICAD-related ischemic stroke who underwent two or more HR-VWI scans. The lumen area (LA), total vessel area (TVA), and enhancing area (EA) of the narrowest part of the culprit lesion were manually segmented. Degree of stenosis was estimated as [1-LA/TVA] × 100(%), the enhancing proportion as EA/TVA × 100(%), and enhancement ratio as (T1GD/T1GD)/(T1/T1). Linear mixed models were used to investigate temporal changes in these parameters and whether such changes differed by etiologies.
Of a total of 208 patients, ICAD-related stroke was caused by atherosclerosis (69%), arterial dissection (24%), vasculitis (3%), moyamoya disease (1%), and other (2%). The median follow-up was 319 [IQR, 125-409] days. HR-VWI imaging parameters, namely, degree of stenosis, enhancing proportion, and enhancement ratio showed a trend to decrease over time. Patients with intracranial dissection as a cause of intracranial narrowing showed a faster reduction in degree of stenosis and enhancing proportion vs. when such narrowing was identified as due to atherosclerosis ( [95% CI], -0.59%[-0.80% ~ -0.38%] and -0.81%[-1.23% ~ -0.39%], respectively, both < 0.01). The enhancement ratio did not change over time in dissection, while it decreased in atherosclerosis (-0.01 [-0.02 ~ 0], = 0.04).
Intracranial vessel narrowing in patients with ischemic stroke changes over time with different stroke etiologies having their own unique temporal patterns.
颅内动脉疾病（ICAD）中血管壁的时间动态变化可能因病因不同而有所差异。我们使用系列高分辨率血管壁成像（HR-VWI）研究了缺血性卒中后颅内动脉狭窄的时间变化。
我们回顾性招募了接受两次或更多次HR-VWI扫描的ICAD相关缺血性卒中患者。对罪犯病变最狭窄部位的管腔面积（LA）、总血管面积（TVA）和强化面积（EA）进行手动分割。狭窄程度估计为[1-LA/TVA]×100（%），强化比例为EA/TVA×100（%），强化率为（T1GD/T1GD）/（T1/T1）。使用线性混合模型研究这些参数的时间变化以及这些变化是否因病因不同而有所差异。
在总共208例患者中，ICAD相关卒中由动脉粥样硬化（69%）、动脉夹层（24%）、血管炎（3%）、烟雾病（1%）和其他（2%）引起。中位随访时间为319[四分位间距，125 - 409]天。HR-VWI成像参数，即狭窄程度、强化比例和强化率显示出随时间下降的趋势。与因动脉粥样硬化导致颅内狭窄的患者相比，因颅内夹层导致颅内狭窄的患者狭窄程度和强化比例下降更快（[95%置信区间]，分别为-0.59%[-0.80%-0.38%]和-0.81%[-1.23%-0.39%]，均<0.01）。夹层患者的强化率随时间无变化，而动脉粥样硬化患者的强化率下降（-0.01[-0.02~0]，=0.04）。
缺血性卒中患者的颅内血管狭窄随时间变化，不同卒中病因有其独特的时间模式。
