Intimal predominant calcification is associated with plaque instability in the vertebrobasilar artery by vessel wall magnetic resonance imaging and computed tomography

Song, Guodong; Liu, Bo; Xue, Chen; Dong, Yin; Yang, Xiaorong; Yin, Qingqing; Wang, Cuiyan; Lin, Liangjie; Yang, Huan; Yang, Guiwen

doi:10.1016/j.ejrad.2023.111132

Cited by 1 publication

(2 citation statements)

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“…A study has found that spotty calcification in nonstenotic carotid atherosclerosis is associated with ischemic stroke on the same side ( 4 ). Other studies have demonstrated the pattern of calcification within the intimal layer was associated with unstable plaque phenotype ( 6 ) and increased stroke risk ( 5 ). In the current study, multiple calcifications had a low sensitivity of 28%, and spotty calcification and intimal predominant calcification have relatively low specificity (54 and 46%) for the presence of culprit lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Scattered and multiple calcifications were proposed to be correlated with a higher wall shear stress, thus potentially triggering embolic stroke and acute cardiovascular events ( 4 ). Intimal-predominant calcification was associated with an increased risk of stroke and plaque instability in intracranial arteries ( 5 , 6 ). Nevertheless, the interpretation and analysis of calcification morphology remain restricted to the expertise of radiologists.…”

Section: Introductionmentioning

confidence: 99%

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CT texture analysis of vertebrobasilar artery calcification to identify culprit plaques

Liu,

Xue,

et al. 2024

Front. Neurol.

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ObjectivesThe aim of this study was to extract radiomic features from vertebrobasilar artery calcification (VBAC) on head computed tomography (CT) images and investigate its diagnostic performance to identify culprit lesions responsible for acute cerebral infarctions.MethodsPatients with intracranial atherosclerotic disease who underwent vessel wall MRI (VW-MRI) and head CT examinations from a single center were retrospectively assessed for VBAC visual and textural analyses. Each calcified plaque was classified by the likelihood of having caused an acute cerebral infarction identified on VW-MRI as culprit or non-culprit. A predefined set of texture features extracted from VBAC segmentation was assessed using the minimum redundancy and maximum relevance method. Five key features were selected to integrate as a radiomic model using logistic regression by the Aikaike Information Criteria. The diagnostic value of the radiomic model was calculated for discriminating culprit lesions over VBAC visual assessments.ResultsA total of 1,218 radiomic features were extracted from 39 culprit and 50 non-culprit plaques, respectively. In the VBAC visual assessment, culprit plaques demonstrated more observed presence of multiple calcifications, spotty calcification, and intimal predominant calcification than non-culprit lesions (all p < 0.05). In the VBAC texture analysis, 55 (4.5%) of all extracted features were significantly different between culprit and non-culprit plaques (all p < 0.05). The radiomic model incorporating 5 selected features outperformed multiple calcifications [AUC = 0.81 with 95% confidence interval (CI) of 0.72, 0.90 vs. AUC = 0.61 with 95% CI of 0.49, 0.73; p = 0.001], intimal predominant calcification (AUC = 0.67 with 95% CI of 0.58, 0.76; p = 0.04) and spotty calcification (AUC = 0.62 with 95% CI of 0.52, 0.72; p = 0.005) in the identification of culprit lesions.ConclusionCulprit plaques in the vertebrobasilar artery exhibit distinct calcification radiomic features compared to non-culprit plaques. CT texture analysis of VBAC has potential value in identifying lesions responsible for acute cerebral infarctions, which may be helpful for stroke risk stratification in clinical practice.

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Section: Discussionmentioning

confidence: 99%