Culprit Plaque in Acute Cerebral Infarction: A Histological and MRI Assessment

描述(申请人提供)：在美国，每40秒就有一人中风。中风总体上是第四大死因(在女性中排名第三)，在美国每18例死亡中就有一例死于中风，在中国中是第三大死因。中国-莫尼卡-北京项目的数据显示，从1984年到2004年，25-74岁人群中缺血性中风的发病率翻了一番，从100.5/10万增加到213.2/10万。中风也是导致长期严重残疾的主要原因。在65岁及以上的缺血性中风幸存者中，50%的人有一些偏瘫，30%的人在没有帮助的情况下无法行走，19%的人有失语症，26%的人在缺血事件发生后6个月被送进养老院。2008年，美国中风的直接和间接成本为343亿美元2，预计2050年的成本超过2.2万亿美元，这促使美国和中国呼吁更多地关注二级中风预防。这项研究的目标是提供成像技术，帮助临床医生为个别患者选择最合适的治疗策略。我们的目标是通过开发改进的方法来检测和定位导致中风的动脉粥样硬化病变，即罪魁祸首斑块，以实现这一目标。此外，我们试图为高危斑块的发展提供新的标记物和危险因素的洞察力。这项研究的结果将为前瞻性研究奠定基础，这些研究将评估MRI检测到的罪魁祸首斑块的存在是否会增加中风复发的风险，以及特定的循环标志物是否会预测进展为高风险斑块。

DESCRIPTION (provided by applicant): Every 40 seconds, one person in the U.S. has a stroke. Stroke is the fourth leading cause of death overall (third leading among women), it accounts for one of every 18 deaths in the U.S., and it is the third leading cause of death in China. Data from the Sino-MONICA-Beijing Project indicate that the incidence of ischemic stroke in 25-74 year old individuals has doubled between 1984 and 2004, from 100.5 to 213.2 per 100,000. Stroke is also the leading cause of serious, long-term disability. Amongst ischemic stroke survivors 65 years of age and older, 50% have some hemiparesis, 30% are unable to walk without assistance, 19% have aphasia, and 26% are institutionalized in a nursing home six months following their ischemic event. In 2008, the direct and indirect cost of stroke in the U.S. was $34.3 billion2 and projected costs in 2050 exceed $2.2 trillion, leading to calls for greater focus on secondary stroke prevention in the U.S. and in China. The goal of this research is to provide imaging techniques that will help clinicians select the most appropriate treatment strategy for the individual patient. We aim to accomplish this goal through development of improved methods for the detection and localization of the atherosclerotic lesion responsible for stroke, referred to as the culprit plaque. Furthermore, we seek to provide insight into novel markers and risk factors for development of the high-risk plaque. Findings from this study will lay the foundation for prospective studies that will assess whether presence of an MRI-detected culprit plaque poses a higher risk for recurrent stroke, and whether specific circulating markers predict progression to a high-risk plaque.