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Follow-up assessment of atherosclerotic plaques in acute ischemic stroke patients using high-resolution vessel wall MR imaging

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

Data on evolution of intracranial plaques in acute ischemic stroke patients after receiving medical therapy is still limited. We aimed to investigate the plaque features associated with culprit lesions and to explore the plaque longitudinal changes during treatment using high-resolution vessel wall MR imaging (VW-MRI).

Methods

Twenty-three patients (16 men; mean age, 51.4 years ± 11.1) with acute ischemic stroke underwent 3-T VW-MRI for intracranial atherosclerosis and were taken follow-up assessments. Each identified plaque was retrospectively classified as culprit, probably culprit, or nonculprit. Plaque features were analyzed at both baseline and follow-up and were compared using paired t-test, paired Wilcoxon test, or McNemar’s test.

Results

A total of 87 intracranial plaques were identified (23 [26.4%] culprit, 10 [11.5%] probably culprit, and 54 [62.1%] nonculprit plaques). The median time interval between initial and follow-up MRI scans was 8.0 months. In the multiple ordinal logistic regression analysis, plaque contrast ratio (CR) (OR, 1.037; 95% CI, 1.013–1.062; P = 0.002) and surface irregularity (OR, 4.768; 95% CI, 1.064–21.349; P = 0.041) were independently associated with culprit plaques. During follow-up, plaque length, maximum thickness, normalized wall index (NWI), stenosis degree, and CR significantly decreased (all P-values < 0.05) in the culprit plaque group. The plaque NWI and CR dropped in the probably culprit plaques (P = 0.041, 0.026, respectively). In the nonculprit plaque group, only plaque NWI and stenosis degree showed significant decrement (P = 0.017, 0.037, respectively).

Conclusion

Follow-up VW-MRI may contribute to plaque risk stratification and may provide valuable insights into the evolution of different plaques in vivo.

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Abbreviations

ICAD:

Intracranial atherosclerotic disease

VW-MRI:

Vessel wall MR imaging

NWI:

Normalized wall index

CR:

Contrast ratio

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People’s Republic of China

    Xuehua Lin, Wei Guo, Dejun She, Feng Wang, Zhen Xing & Dairong Cao

  2. Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China

    Dairong Cao

  3. Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, China

    Dairong Cao

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  1. Xuehua Lin
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  2. Wei Guo
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  3. Dejun She
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  4. Feng Wang
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Contributions

Xuehua Lin performed the study and drafted the manuscript. Material preparation, data collection, image post-processing and analysis were performed by Xuehua Lin, Wei Guo and Dejun She. Feng Wang carried out the statistical analyses. Dairong Cao and Zhen Xing conceived the study idea, participated in its design, and helped in drafting the manuscript. All authors read and approved of the final manuscript.

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Correspondence to Dairong Cao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The study was approved by our institutional review committee. Informed consent was waived off due to the retrospective nature of the study.

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Lin, X., Guo, W., She, D. et al. Follow-up assessment of atherosclerotic plaques in acute ischemic stroke patients using high-resolution vessel wall MR imaging. Neuroradiology 64, 2257–2266 (2022). https://doi.org/10.1007/s00234-022-03002-y

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  • DOI: https://doi.org/10.1007/s00234-022-03002-y

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