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Updated: Aug 6, 2026
A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
Baseline normalized wall index predicts delayed recanalization in internal carotid artery dissection with intramural
Feng Ouyang1, Jie Liu1, Meimei Yan1
1Jiangxi Provincial Key Laboratory for Precision Pathology and Intelligent Diagnosis, Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, China; Clinical Research Center for Medical Imaging in Jiangxi Province, Nanchang, China.
Objective:
This study aims to investigate the evolution of intramural hematoma (IMH) in internal carotid artery dissection (ICAD) and identify predictors of favorable recanalization.
Methods:
This study cohort comprised 53 patients diagnosed with IMH due to ICAD on the basis of high-resolution magnetic resonance vessel wall imaging (HR-VWI) between June 2018 and June 2025. Thirty-eight medically managed patients underwent follow-up imaging. Neuroradiologists blinded to clinical data independently reviewed imaging. The primary outcome was favorable recanalization (<50% luminal stenosis) at follow-up, with the interval from symptom onset to the follow-up HR-VWI examination used as the time scale. Analyses included Cox regression, time-dependent ROC, landmark analysis, and bootstrap validation.
Results:
Among 38 patients with follow-up (median 138.0 days), IMH volume decreased to varying extents. Baseline normalized wall index (NWI) predicted favorable recanalization with an area under the curve (AUC) of 0.75 (95% CI, 0.58-0.87; P = 0.003). Time-dependent ROC analysis demonstrated improving predictive performance over time (AUCs: 0.57 at 90 days, 0.64 at 120 days, and 0.76 at 180 days). NWI cutoff values < 0.94 were associated with favorable recanalization. In multivariate Cox regression, NWI (adjusted hazard ratio, 0.13; 95% CI, 0.03-0.51; P = 0.003) was independently associated with the primary outcome. Landmark analysis at 90 days validated NWI's predictive value for delayed recanalization (AUC = 0.73). Bootstrap validation yielded an optimism-corrected AUC of 0.74 and C-index of 0.77.
Conclusion:
Baseline NWI is an independent predictor of favorable recanalization in ICAD-IMH, with time-dependent efficacy. This underscores the potential value of HR-VWI in guiding therapeutic reassessment in patients with ICAD-IMH.
