Intracranial Atherosclerotic Plaque Characteristics and Burden Associated With Recurrent Acute Stroke: A 3D Quantitative Vessel Wall MRI Study.
Intracranial Atherosclerotic Plaque Characteristics and Burden Associated With Recurrent Acute Stroke: A 3D Quantitative Vessel Wall MRI Study.
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颅内动脉粥样硬化斑块特征和与复发性急性中风相关的负担：3D 定量血管壁 MRI 研究
DOI：
10.3389/fnagi.2021.706544
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发表时间：
2021
影响因子：
4.8
通讯作者：
Zhu C
中科院分区：
文献类型：
--
作者：
Sun B;Wang L;Li X;Zhang J;Zhang J;Liu X;Wu H;Mossa-Basha M;Xu J;Zhao B;Zhao H;Zhou Y;Zhu C
背景：颅内动脉硬化性疾病(ICAD)往往影响多个动脉节段，以往的研究很少对Willis环的整个斑块进行全面的斑块分析以评估复发的中风风险。本研究旨在探讨Willis ICAD环在三维磁共振血管壁成像(MR-VW I)上的表现及其与复发急性卒中的关系。方法：对急性缺血性卒中(卒中后4周内)和慢性缺血性卒中(卒中后3个月后)的患者进行了覆盖大脑主要动脉的3D增强MR-VWI检查。参与者被分为三组：首次急性卒中、反复急性卒中和慢性卒中。在三组患者中测量并比较罪犯斑块(当多个斑块出现在卒中的同一血管区域时，定义为唯一的病变或最狭窄的病变)和非罪犯斑块的特征，包括斑块总数、斑块厚度、斑块面积、斑块负荷(斑块面积除以外壁面积)、强化比(ER)、偏心率和狭窄程度。用多因素分析研究斑块特征与复发急性卒中之间的关系。结果：共176例受试者(年龄61±10岁，男性109例)，共702个颅内斑块。其中首次急性卒中80例，复发性急性卒中42例，慢性卒中54例。复发性急性卒中组较首次急性卒中组和慢性卒中组患者均有更多的颅内斑块(5.19±1.9比3.71±1.96和3.46±1.33，p<；0.001)。复发急性卒中组患者的罪犯斑块负担(P<；0.001)和罪犯ER(P<；0.001)高于其他两组。调整临床人口学因素后，多因素分析显示冠心病(优势比OR=4.6 1；p=0.035)、总斑块数(OR=1.5 4；p=0.003)、罪犯斑块ER(OR=2.5 0；p=0.036)、罪犯斑块负担(OR每10%增量OR=2.44；p=0.010)均与首次发病的急性卒中独立相关。结论：颅内动脉粥样硬化斑块数目增加、罪犯斑块ER增加、罪犯斑块负荷增加和冠心病与复发的急性卒中独立相关。
Background: Intracranial atherosclerotic disease (ICAD) tends to affect multiple arterial segments, and previous studies rarely performed a comprehensive plaque analysis of the entire circle of Willis for the evaluation of recurrent stroke risk. We aimed to investigate the features of circle of Willis ICAD on 3D magnetic resonance vessel wall imaging (MR-VWI) and their relationships with recurrent acute stroke. Methods: Patients with either acute ischemic stroke (within 4 weeks after stroke) or chronic ischemic stroke (after 3 months of stroke) due to intracranial atherosclerotic plaque underwent 3D contrast-enhanced MR-VWI covering major cerebral arteries. Participants were divided into three groups: first-time acute stroke, recurrent acute stroke, and chronic stroke. Culprit plaque (defined as the only lesion or the most stenotic lesion when multiple plaques were present within the same vascular territory of the stroke) and non-culprit plaque characteristics, including total plaque number, plaque thickness, plaque area, plaque burden (calculated as plaque area divided by outer wall area), enhancement ratio (ER), eccentricity, and stenosis, were measured and compared across the three groups. Associations between plaque characteristics and recurrent acute stroke were investigated by multivariate analysis. Results: A total of 176 participants (aged 61 ± 10 years, 109 men) with 702 intracranial plaques were included in this study. There were 80 patients with first-time acute stroke, 42 patients with recurrent acute stroke, and 54 patients with chronic stroke. More intracranial plaques were found per patient in the recurrent acute stroke group than in the first-time acute stroke or chronic stroke group (5.19 ± 1.90 vs. 3.71 ± 1.96 and 3.46 ± 1.33, p < 0.001). Patients in the recurrent acute stroke group had greater culprit plaque burden (p < 0.001) and higher culprit ER (p < 0.001) than the other two groups. After adjustment of clinical demographic factors, in multivariate analysis, coronary artery disease (CAD) (odds ratio, OR = 4.61; p = 0.035), total plaque number (OR = 1.54; p = 0.003), culprit plaque ER (OR = 2.50; p = 0.036), and culprit plaque burden (OR per 10% increment = 2.44; p = 0.010) were all independently associated with recurrent acute stroke compared to the first-time acute stroke. Conclusion: Increased intracranial atherosclerotic plaque number, higher culprit plaque ER, greater culprit plaque burden, and CAD are independently associated with recurrent acute stroke.
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影响因子：
8.3
作者：
Qiao Y;Anwar Z;Intrapiromkul J;Liu L;Zeiler SR;Leigh R;Zhang Y;Guallar E;Wasserman BA
通讯作者：
Wasserman BA
影响因子：
29
作者：
Hoshino, Takao;Sissani, Leila;Amarenco, Pierre
通讯作者：
Amarenco, Pierre
DOI：
10.2214/ajr.15.14534
发表时间：
2015-09
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Hope MD;Hope TA;Zhu C;Faraji F;Haraldsson H;Ordovas KG;Saloner D
通讯作者：
Saloner D
影响因子：
2.9
作者：
Kim, Jong Hae
通讯作者：
Kim, Jong Hae
影响因子：
8.3
作者：
Coull, AJ;Rothwell, PM
通讯作者：
Rothwell, PM