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Distinguishing stroke from transient ischemic attack using plaque characteristics and arterial transit artifacts
Ling Li1, Peichun Pan2, Na Zhang1
1Shaanxi Provincial People's Hospital, Xi'an, China.
Frontiers in Neurology
|April 7, 2025
Summary
High-resolution MRI and ASL imaging effectively differentiate stroke from TIA by analyzing plaque characteristics and arterial transit artifacts. This combined approach offers superior diagnostic performance for identifying ischemic stroke.
Area of Science:
- Neuroimaging
- Cerebrovascular Diseases
- Radiology
Background:
- Distinguishing between ischemic stroke and transient ischemic attack (TIA) is crucial for appropriate patient management.
- Cerebral plaque characteristics and hemodynamics play a significant role in the pathophysiology of these events.
- Advanced imaging techniques are needed to accurately assess these factors.
Purpose of the Study:
- To compare plaque characteristics and hemodynamics in patients with ischemic stroke versus TIA.
- To evaluate the diagnostic capabilities of high-resolution magnetic resonance imaging (HRMRI) and arterial spin labeling (ASL) in differentiating stroke from TIA.
- To assess the combined diagnostic performance of HRMRI and ASL, including arterial transit artifacts (ATAs).
Main Methods:
- Retrospective analysis of 147 patients (stroke n=79, TIA n=68) who underwent HRMRI and ASL.
- Comparison of clinical risk factors, vascular plaque characteristics (positive remodeling, intraplaque hemorrhage, enhancement ratio), and ATAs at different post-labeling delays (PLDs).
- Multivariate logistic regression used to evaluate diagnostic performance of prediction models.
Main Results:
- Significant differences in plaque characteristics and the presence of ATAs were found between stroke and TIA groups (p < 0.05).
- Combined HRMRI and ASL demonstrated high diagnostic performance (AUC, 0.926) in distinguishing ischemic stroke from TIA.
- No significant difference in diagnostic performance for ischemic stroke was observed between HRMRI and ASL alone.
Conclusions:
- A model incorporating plaque characteristics and ATAs shows good diagnostic performance for differentiating TIA from stroke in intracranial atherosclerotic stenosis.
- Arterial spin labeling (ASL) offers a simpler imaging evaluation method compared to HRMRI.
- ATA evaluation is a promising imaging marker for clinical use in cerebrovascular disease diagnosis.
Keywords:
arterial spin labelingarterial transit artifactshigh-resolution MRIstroketransient ischemic attackMore Related Videos
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