Large Culprit Plaque and More Intracranial Plaques Are Associated with Recurrent Stroke: A Case-Control Study Using
1From The School of Medicine (G.W., H.W.), Nankai University, Tianjin, China.
AJNR. American Journal of Neuroradiology
|January 21, 2022
Summary
Large culprit plaque volume and a higher number of intracranial plaques are independent predictors of recurrent stroke. Whole-brain imaging can identify patients at increased risk for stroke recurrence.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Research
Background:
- Intracranial atherosclerotic plaque characteristics are linked to recurrent stroke.
- Previous research often focused on single lesions, neglecting perfusion deficits.
- A comprehensive analysis of whole-brain plaque features and perfusion is needed.
Purpose of the Study:
- To investigate the association between whole-brain plaque features, perfusion deficits, and stroke recurrence.
- To identify specific plaque characteristics indicative of recurrent stroke risk.
Main Methods:
- Retrospective collection of ischemic stroke patients due to intracranial atherosclerosis.
- High-resolution vessel wall imaging and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI).
- Logistic regression analysis to determine independent predictors of recurrent stroke.
Main Results:
- Recurrent stroke patients had larger culprit plaque volume and more intracranial plaques compared to first-time stroke patients.
- Culprit plaque volume (OR, 1.16) and total plaque number (OR, 1.31) were independently associated with recurrent stroke.
- Combining these factors improved the predictive model's area under the curve to 0.71.
Conclusions:
- Significant culprit plaque volume and a higher number of intracranial plaques are independently associated with recurrent stroke.
- Whole-brain vessel wall imaging aids in identifying patients at higher risk for recurrent stroke.
- This approach enhances risk stratification for stroke recurrence in intracranial atherosclerosis.
