Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study
单位：[1]Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.[2]Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.[3]Department of Neurology, Jining People's Hospital, Jining, China.[4]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.四川大学华西医院[5]Department of Neurology, Tangshan Gongren Hospital, Tangshan, China.[6]Department of Neurology, Subei People's Hospital of Jiangsu Province, Yangzhou, China.[7]Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.神经内科神经科华中科技大学同济医学院附属同济医院[8]Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.[9]Department of Neurology, Hebei General Hospital, Shijiazhuang, China.[10]Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China.[11]Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.首都医科大学附属安贞医院[12]Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China.[13]Department of Neurology, People's Hospital Ningxia Hui Autonomous Region, Yinchuan, China.[14]Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.[15]Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.[16]Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China.
High-resolution magnetic resonance vessel wall imaging (HRMR-VWI) is a promising technique for identifying intracranial vulnerable plaques beyond lumen narrowing. However, the association between HRMR-VWI characteristics and recurrent stroke remains uncertain. Aims: This study aimed to investigate the association between HRMR-VWI characteristics and recurrent ipsilateral stroke in patients with symptomatic intracranial atherosclerotic steno-occlusive disease (ICAS).This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. Participants were assessed by multi-parametric MRI including diffusion-weighted imaging, three-dimension time-of-flight magnetic resonance angiography, and three-dimensional T1-weighted HRMR-VWI. The patients were recommended to receive best medical therapy and were systematically followed up for 12 months. The association between HRMR-VWI characteristics and the time to recurrent ipsilateral stroke was investigated by univariable and multivariable analysis.Two hundred and fifty-five consecutive patients were enrolled from 15 centers. The cumulative 12-month ipsilateral recurrence incidence was 4.1% (95% confidence interval [CI]: 1.6-6.6%). Patients with recurrent ipsilateral stroke exhibited higher rates of intraplaque hemorrhage (IPH) (30.0% vs. 6.5%) and eccentric plaque (90.0% vs. 48.2%), and lower occurrence of occlusive thrombus (10.0% vs. 23.7%). Plaque length (5.69±2.21 mm vs. 6.67±4.16 mm), plaque burden (78.40±7.37% vs. 78.22±8.32%), degree of stenosis (60.25±18.95% vs. 67.50±22.09%) and remodeling index (1.07±0.27 vs. 1.03±0.35) on HRMR-VWI did not differ between patients with and without recurrent ipsilateral stroke. In the multivariable Cox regression analysis, IPH (hazard ratio: 6.64, 95% CI: 1.23-35.8, p=0.028) was significantly associated with recurrent ipsilateral stroke after adjustment.Our results suggest IPH is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.Data from this study is available and can be accessed upon request.
基金：
This study was supported by the National Science Fund for Distinguished Young
Scholars (82025013), the Ministry of Science and Technology of the People's Republic of
China (2017YFC1307900, 2017YFC1307902), the National High Level Hospital Clinical
Research Funding (2022-PUMCH-C-001; 2022-PUMCH-D-007) and the CAMS Innovation
Fund for Medical Sciences (2022-I2M-1-002).
第一作者单位：[1]Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
通讯作者：
推荐引用方式(GB/T 7714)：
Yuan Weizhuang,Liu Xiaoyun,Yan Zhongrui,et al.Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study[J].INTERNATIONAL JOURNAL OF STROKE.2024,17474930241228203.doi:10.1177/17474930241228203.
APA：
Yuan Weizhuang,Liu Xiaoyun,Yan Zhongrui,Wu Bo,Lu Baoquan...&Xu Wei-Hai.(2024).Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study.INTERNATIONAL JOURNAL OF STROKE,,
MLA：
Yuan Weizhuang,et al."Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study".INTERNATIONAL JOURNAL OF STROKE .(2024):17474930241228203
