Predictive power of high-resolution vessel wall magnetic resonance imaging in ischemic stroke
Shu-Jia Zhai1, Lin Jia1, Han-Jiaerbieke Kukun1
1Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi 830054, China.
Insights
High-resolution vessel wall MRI (HR-VW-MRI) can identify high-risk atherosclerotic plaques in patients with intracranial atherosclerotic disease (ICAD). These findings aid in preventing stroke and guiding clinical treatment for ICAD.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Disease
Background:
- Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke with high recurrence rates.
- Understanding plaque characteristics is crucial for predicting stroke risk in ICAD patients.
Purpose of the Study:
- To evaluate the utility of high-resolution vessel wall MRI (HR-VW-MRI) in assessing plaque features in ICAD patients.
- To identify imaging markers predictive of stroke events in ICAD.
Main Methods:
- Prospective enrollment of 70 ICAD patients undergoing HR-VW-MRI.
- Clinical data collection and telephone follow-up every three months.
- Analysis of plaque characteristics and correlation with ischemic stroke events.
Main Results:
- 169 plaques were identified in 70 patients; 44 plaques were associated with 10 stroke events during follow-up.
- Significant differences in plaque features (EI, HST1, surface features, WA reference) were observed between groups with and without events (P < 0.05).
- Grade 2 enhancements, stenosis ≥ 50%, HST1, and surface features were independent predictors of stroke onset.
Conclusions:
- HR-VW-MRI effectively identifies atherosclerotic plaques and high-risk features in cerebral arteries.
- This imaging modality can aid in the prevention of ICAD and inform clinical management strategies.
Background And Objective:
Intracranial atherosclerotic disease (ICAD) is a key contributor to ischemic stroke and has a high recurrence rate. This study aimed to investigate the function of high-resolution vessel wall MRI (HR-VW-MRI) and evaluate plaque characteristics in patients with ICAD.
Methods:
A consecutive series of patients with ICAD who underwent HR-VW-MRI were enrolled, and imaging measurements were acquired. Baseline clinical characteristics were identified. Telephone follow-up was conducted every three months. The endpoint events were the first onset or recurrence of ischemic stroke and new clinical vascular events. Patients were divided into groups with or without events according to whether the endpoint event occurred.
Results:
A total of 70 patients (mean age = 57.6 years old) were enrolled. The median follow-up duration was 182 days. During the follow-up, 10 patients developed ischemic stroke, experienced endpoint events, and were found with 44 plaques in the artery area. A total of 169 plaques were further found in 70 patients. There were significant differences in EI, HST1, surface features, and WA reference between the two groups (P < 0.05). Logistic analysis showed that grade 2 enhancements, stenosis degree ≥ 50%, HST1, and surface features were independent prognostic factors of the onset of stroke, caused by ICAD.
Conclusion:
This prospective study demonstrates that HR-VW-MRI can identify atherosclerotic plaques in the cerebral artery and high-risk plaques, which may contribute to the prevention of ICAD and guide clinical treatment.
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