Diabetes-specific characteristics of intracranial artery atherosclerosis: a magnetic resonance vessel wall imaging study

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-08-25 DOI:10.1016/j.jocn.2025.111585

Taichun Qiu , Bing Ming , Dandan Yang , Huiyu Qiao , Ning Xu , Rui Shen , Yongjun Han , Xihai Zhao , ICASMAP investigators

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引用次数: 0

Abstract

Background

While diabetes mellitus (DM) is an established risk factor for intracranial atherosclerotic disease (ICAD), its impact on plaque characteristics across different intracranial vascular territories remains unclear.

Methods

Patients with symptomatic intracranial artery stenosis were recruited from a multi-center study of ICASMAP. Plaque characteristics, including the location, plaque burden measured by normalized wall index (NWI), luminal stenosis, length, T1 hyperintense, enhancement grade, and the enhancement ratio of atherosclerotic plaques were evaluated. Plaque characteristics were compared between patients with and without DM and the association between DM and plaque characteristics was analyzed.

Results

Of 171 recruited patients (mean age: 59.1 ± 8.9 years; 91 males), 76 (44.4 %) had DM. Diabetic patients had significantly greater luminal stenosis (49.6 %±25.6 % vs. 29.3 %±18.0 %, P < 0.001), length of plaque (9.3 ± 2.9 mm vs. 7.9 ± 3.9 mm, P = 0.001), NWI (82.9 %±13.0 % vs. 75.9 %±15.4 %, P = 0.012), plaque enhancement Grade 0 (22.4 % vs. 48.0 %, P = 0.005), and plaque enhancement Grade 1 (72.4 % vs. 48.0 %, P = 0.009) in the ophthalmic and communion segment of the internal carotid artery compared with non-diabetic patients. In the basilar artery, there were significant differences in luminal stenosis (57.5 %±28.3 % vs. 42.5 %±25.8 %, P = 0.026), length of plaque (16.6 ± 8.2 mm vs. 10.2 ± 5.3 mm, P < 0.001), and plaque enhancement Grade 1 (77.1 % vs. 51.4 %, P = 0.025) between diabetic and non-diabetic patients. No significant differences were observed in the M1-2 segment of the middle cerebral artery or the V4 segment of the vertebral artery. Adjusting for confounding factors, the differences remained statistically significant in luminal stenosis (P = 0.001), NWI (P = 0.011), plaque enhancement Grade 1 (P = 0.033), and plaque enhancement Grade 2 (P = 0.048) in the ophthalmic and communion segments of internal carotid artery and luminal stenosis (P = 0.001), length of plaque (P = 0.006) in basilar artery between diabetic and non-diabetic patients.

Conclusion

DM differentially affects atherosclerotic plaque characteristics across intracranial artery segments, predominantly the ophthalmic and communion segments of the internal carotid artery and basilar artery.

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颅内动脉粥样硬化的糖尿病特异性特征：磁共振血管壁成像研究

虽然糖尿病（DM）是颅内动脉粥样硬化性疾病（ICAD）的危险因素，但其对颅内不同血管区域斑块特征的影响尚不清楚。方法从ICASMAP多中心研究中招募有症状的颅内动脉狭窄患者。评估斑块特征，包括动脉粥样硬化斑块的位置、归一化壁指数（NWI）测量的斑块负荷、管腔狭窄、长度、T1高强度、增强等级和增强比例。比较糖尿病患者和非糖尿病患者的斑块特征，并分析糖尿病与斑块特征之间的关系。结果171例入组患者(平均年龄：59.1±8.9岁；91男性),76例(44.4%)有DM。糖尿病患者有更高的管腔狭窄(49.6%±25.6%比29.3%±18.0%,P & lt; 0.001),斑块的长度(9.3±2.9毫米和7.9±3.9毫米,P = 0.001), NWI(82.9%±13.0%比75.9%±15.4%,P = 0.012),血小板增强级0(22.4%比48.0%,P = 0.005)和血小板增强1级(72.4%比48.0%,P = 0.009)在眼科和圣餐段颈内动脉与非糖尿病患者相比。在基底动脉，糖尿病患者与非糖尿病患者在管腔狭窄（57.5%±28.3% vs. 42.5%±25.8%,P = 0.026）、斑块长度（16.6±8.2 mm vs. 10.2±5.3 mm, P < 0.001）和斑块增强1级（77.1% vs. 51.4%, P = 0.025）方面存在显著差异。大脑中动脉M1-2段和椎动脉V4段无明显差异。校正混杂因素后，糖尿病患者与非糖尿病患者颈内动脉眼段和共节段管腔狭窄（P = 0.001）、NWI （P = 0.011）、斑块增强1级（P = 0.033）、斑块增强2级（P = 0.048）、基底动脉管腔狭窄（P = 0.001）、斑块长度（P = 0.006）差异仍有统计学意义。结论dm对颅内各动脉段动脉粥样硬化斑块特征的影响存在差异，主要影响颈内动脉和基底动脉的眼段和共段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.