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Risk of acute cerebral infarction in patients with hypertension based on high-resolution MRI

Wanchen Liu1,2, Zhiji Zheng3, Zhe Feng1

  • 1Department of Radiology, Huashan Hospital Fudan University, Shanghai, China.

Quantitative Imaging in Medicine and Surgery
|April 16, 2025
PubMed

Insights

Hypertension severity and duration, along with specific carotid plaque features like intraplaque hemorrhage and enhancement, are linked to acute cerebral infarction (ACI) occurrence and severity in hypertensive patients.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Hypertension is a known risk factor for carotid plaque formation and acute cerebral infarction (ACI).
  • Understanding the link between vulnerable carotid plaques and ACI severity is crucial for patient management.

Purpose of the Study:

  • To investigate the correlation between high-resolution magnetic resonance imaging (HR-MRI) characteristics of vulnerable carotid plaques and the severity of ipsilateral ACI in patients with hypertension.

Main Methods:

  • Retrospective collection of HR-MRI carotid plaque data from hypertensive patients.
  • Patients categorized into ACI and non-ACI groups based on diffusion-weighted imaging.
  • ACI severity assessed using National Institutes of Health Stroke Scale (NIHSS) scores; logistic regression analysis performed.

Main Results:

  • Hypertensive patients with ACI showed longer hypertension duration, higher hypertension grade, elevated serum creatinine, and HbA1c.
  • Intraplaque hemorrhage (IPH) and plaque enhancement were more prevalent in the ACI group.
  • Hypertension grade, duration, serum creatinine, IPH, and plaque enhancement were risk factors for ACI; Grade 3 hypertension and surface irregularity correlated with more severe ACI.

Conclusions:

  • Carotid plaque characteristics visualized by HR-MRI, in conjunction with hypertension grade and duration, are associated with both the occurrence and severity of ipsilateral ACI.
  • HR-MRI offers valuable insights into plaque vulnerability in hypertensive patients at risk for stroke.
  • These findings may aid in refining risk stratification and treatment strategies for hypertensive individuals.
Abstract

Keywords:
Carotid plaqueacute cerebral infarction (ACI)high-resolution magnetic resonance imaging (HR-MRI)hypertension

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