Characteristics of symptomatic plaque on high-resolution magnetic resonance imaging and its relationship with the occurrence and recurrence of ischemic stroke

Zhao, Jie-Ji; Lü, Yue; Cui, Jun-Yi; Ma, Linqing; Zhang, Run-Ping; Xu, Zai‐Quan

doi:10.1007/s10072-021-05457-y

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…Previous studies on intracranial hr-vw-MRI have shown that plaque enhancement is a significant marker that is strongly linked to culprit lesions and clinical outcomes. However, our findings do not entirely align with these studies ( Lu et al, 2021 ; Zhang et al, 2021 ; Zhao et al, 2021 ), as we discovered that the enhancement ratio was considerably higher in culprit lesions than in non-culprit ones, rather than in most stenotic plaques across the entire plaque. It could be interpreted with the following considerations.…”

Section: Discussioncontrasting

confidence: 99%

Characteristics of culprit intracranial plaque without substantial stenosis in ischemic stroke using three-dimensional high-resolution vessel wall magnetic resonance imaging

et al. 2023

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Background and aimsWe aim to analyze the difference in quantitative features between culprit and non-culprit intracranial plaque without substantial stenosis using three-dimensional high-resolution vessel wall MRI (3D hr-vw-MRI).MethodsThe patients with cerebral ischemic symptoms of the unilateral anterior circulation were recruited who had non-stenotic intracranial atherosclerosis (<50%) confirmed by computed tomographic angiographic (CTA) or magnetic resonance angiography (MRA). All patients underwent 3D hr-vw MRI within 1 month after symptom onset. 3D hr-vw-MRI characteristics, including wall thickness, plaque burden, enhancement ratio, plaque volume and intraplaque hemorrhage, and histogram features were analyzed based on T2-, precontrast T1-, and post-contrast T1-weighted images. Univariate and multivariate logistic regression analysis were used to identify key determinates differentiating culprit and non-culprit plaques and to calculate the odds ratios (ORs) with 95% confidence intervals (CIs).ResultsA total of 150 plaques were identified, of which 133 plaques (97 culprit and 36 non-culprit) were in the middle cerebral artery, three plaques (all culprit) were in the anterior cerebral artery (ACA) and 14 (11 culprit and three non-culprit) were in the internal carotid artery (ICA). Of all the quantitative parameters analyzed, plaque volume, maximum wall thickness, minimum wall thickness, plaque burden, enhancement ratio, coefficient of variation of the most stenotic site, enhancement ratio of whole culprit plaque in culprit plaques were significantly higher than those in non-culprit plaques. Multivariate logistic regression analysis found that plaque volume [OR, 1.527 (95% CI, 1.231–1.894); P < 0.001] and enhancement ratio of whole plaque [OR, 1.095 (95% CI, 1.021–1.175); P = 0.011] were significantly associated with culprit plaque. The combination of the two features obtained a better diagnostic efficacy for culprit plaque with sensitivity and specificity (0.910 and 0.897, respectively) than each of the two parameters alone.Conclusion3D hr-vw MRI features of intracranial atherosclerotic plaques provided potential values over prediction of ischemic stroke patients with non-stenotic arteries. The plaque volume and enhancement ratio of whole plaque of stenosis site were found to be effective predictive parameters.

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Section: Discussioncontrasting

confidence: 99%

Characteristics of culprit intracranial plaque without substantial stenosis in ischemic stroke using three-dimensional high-resolution vessel wall magnetic resonance imaging

et al. 2023

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“…The related methods to measure were as follows: (1) IPH: On T 1 WI, the signal intensity of plaque exceeded 150% of normal brain parenchyma. ; (2) PE was classified as mild and apparent enhancement based on a comparison of plaque enhancement with the pituitary funnel stalk; (3) The wall remodeling pattern was divided into positive and negative patterns according to the ratio of the vessel area at the site of maximum luminal stenosis to the reference vessel area; (4) Diameter stenosis rate = [1 – narrow lumen area/reference lumen area] × 100% ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

“…According to previous studies, the traditional radiological models were constructed based on IPH, PE, wall remodeling pattern, and lumen stenosis rates ( 18 , 21 ). Finally, a combined model was built based on the conventional radiological and radiomics characteristics, and the corresponding nomogram was established by the R software.…”

Section: Methodsmentioning

confidence: 99%

Identifying vulnerable plaques: A 3D carotid plaque radiomics model based on HRMRI

Zhang

Hua²,

Chen³

et al. 2023

Front. Neurol.

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BackgroundIdentification of vulnerable carotid plaque is important for the treatment and prevention of stroke. In previous studies, plaque vulnerability was assessed qualitatively. We aimed to develop a 3D carotid plaque radiomics model based on high-resolution magnetic resonance imaging (HRMRI) to quantitatively identify vulnerable plaques.MethodsNinety patients with carotid atherosclerosis who underwent HRMRI were randomized into training and test cohorts. Using the radiological characteristics of carotid plaques, a traditional model was constructed. A 3D carotid plaque radiomics model was constructed using the radiomics features of 3D T1-SPACE and its contrast-enhanced sequences. A combined model was constructed using radiological and radiomics characteristics. Nomogram was generated based on the combined models, and ROC curves were utilized to assess the performance of each model.Results48 patients (53.33%) were symptomatic and 42 (46.67%) were asymptomatic. The traditional model was constructed using intraplaque hemorrhage, plaque enhancement, wall remodeling pattern, and lumen stenosis, and it provided an area under the curve (AUC) of 0.816 vs. 0.778 in the training and testing sets. In the two cohorts, the 3D carotid plaque radiomics model and the combined model had an AUC of 0.915 vs. 0.835 and 0.957 vs. 0.864, respectively. In the training set, both the radiomics model and the combination model outperformed the traditional model, but there was no significant difference between the radiomics model and the combined model.ConclusionsHRMRI-based 3D carotid radiomics models can improve the precision of detecting vulnerable carotid plaques, consequently improving risk classification and clinical decision-making in patients with carotid stenosis.

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“…HR-VWI can provide detailed information about the anatomy of MMD and the abnormal vascular network, which can help assess the risk of ischemia or hemorrhage in MMD ( Lu et al, 2021 ; Zhao et al, 2021 ). One study studied 29 patients with MMD using 3.0 T HR-VWI intracranial vessel wall imaging and found that VWE was positively correlated with ischemic events ( Kathuveetil et al, 2020 ).…”

Section: Application Of Hr-vwi In MMDmentioning

confidence: 99%

High-resolution magnetic resonance vessel wall imaging provides new insights into Moyamoya disease

Yang,

Huang,

et al. 2024

Front. Neurosci.

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Moyamoya disease (MMD) is a rare condition that affects the blood vessels of the central nervous system. This cerebrovascular disease is characterized by progressive narrowing and blockage of the internal carotid, middle cerebral, and anterior cerebral arteries, which results in the formation of a compensatory fragile vascular network. Currently, digital subtraction angiography (DSA) is considered the gold standard in diagnosing MMD. However, this diagnostic technique is invasive and may not be suitable for all patients. Hence, non-invasive imaging methods such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are often used. However, these methods may have less reliable diagnostic results. Therefore, High-Resolution Magnetic Resonance Vessel Wall Imaging (HR-VWI) has emerged as the most accurate method for observing and analyzing arterial wall structure. It enhances the resolution of arterial walls and enables quantitative and qualitative analysis of plaque, facilitating the identification of atherosclerotic lesions, vascular entrapment, myofibrillar dysplasia, moyamoya vasculopathy, and other related conditions. Consequently, HR-VWI provides a new and more reliable evaluation criterion for diagnosing vascular lesions in patients with Moyamoya disease.

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Characteristics of symptomatic plaque on high-resolution magnetic resonance imaging and its relationship with the occurrence and recurrence of ischemic stroke

Cited by 9 publications

References 40 publications

Characteristics of culprit intracranial plaque without substantial stenosis in ischemic stroke using three-dimensional high-resolution vessel wall magnetic resonance imaging

Characteristics of culprit intracranial plaque without substantial stenosis in ischemic stroke using three-dimensional high-resolution vessel wall magnetic resonance imaging

Identifying vulnerable plaques: A 3D carotid plaque radiomics model based on HRMRI

High-resolution magnetic resonance vessel wall imaging provides new insights into Moyamoya disease

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