颅内动脉粥样硬化性狭窄闭塞症患者的高分辨率磁共振血管壁成像特征与复发性中风之间的关系:一项前瞻性多中心研究。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
International Journal of Stroke Pub Date : 2024-06-01 Epub Date: 2024-02-15 DOI:10.1177/17474930241228203
Weizhuang Yuan, Xiaoyun Liu, Zhongrui Yan, Bo Wu, Baoquan Lu, Beilei Chen, Daishi Tian, Ailian Du, Litao Li, Changyun Liu, Guangzhi Liu, Tao Gong, Zhimin Shi, Feng Feng, Caiyan Liu, Yao Meng, Qianqian Lin, Mingli Li, Wei-Hai Xu
{"title":"颅内动脉粥样硬化性狭窄闭塞症患者的高分辨率磁共振血管壁成像特征与复发性中风之间的关系:一项前瞻性多中心研究。","authors":"Weizhuang Yuan, Xiaoyun Liu, Zhongrui Yan, Bo Wu, Baoquan Lu, Beilei Chen, Daishi Tian, Ailian Du, Litao Li, Changyun Liu, Guangzhi Liu, Tao Gong, Zhimin Shi, Feng Feng, Caiyan Liu, Yao Meng, Qianqian Lin, Mingli Li, Wei-Hai Xu","doi":"10.1177/17474930241228203","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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).</p><p><strong>Methods: </strong>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 multiparametric magnetic resonance imaging (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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.028) was significantly associated with recurrent ipsilateral stroke after adjustment.Conclusions:Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.</p><p><strong>Data access statement: </strong>Data from this study are available and can be accessed upon request.</p>","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":null,"pages":null},"PeriodicalIF":6.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Weizhuang Yuan, Xiaoyun Liu, Zhongrui Yan, Bo Wu, Baoquan Lu, Beilei Chen, Daishi Tian, Ailian Du, Litao Li, Changyun Liu, Guangzhi Liu, Tao Gong, Zhimin Shi, Feng Feng, Caiyan Liu, Yao Meng, Qianqian Lin, Mingli Li, Wei-Hai Xu\",\"doi\":\"10.1177/17474930241228203\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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).</p><p><strong>Methods: </strong>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 multiparametric magnetic resonance imaging (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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.028) was significantly associated with recurrent ipsilateral stroke after adjustment.Conclusions:Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.</p><p><strong>Data access statement: </strong>Data from this study are available and can be accessed upon request.</p>\",\"PeriodicalId\":14442,\"journal\":{\"name\":\"International Journal of Stroke\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.3000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17474930241228203\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930241228203","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:高分辨率磁共振血管壁成像(HRMR-VWI)是一种很有前途的技术,可用于识别管腔狭窄以外的颅内易损斑块。然而,HRMR-VWI 特征与复发性卒中之间的关系仍不确定。目的:本研究旨在探讨无症状颅内动脉粥样硬化性狭窄闭塞症(ICAS)患者的 HRMR-VWI 特征与复发性同侧中风之间的关系:这项多中心观察性研究招募了发病后 7 天内归因于 ICAS(>50% 狭窄或闭塞)的首次急性缺血性卒中患者。研究人员对患者进行了多参数磁共振成像评估,包括弥散加权成像、三维飞行时间磁共振血管造影和三维 T1 加权 HRMR-VWI。建议患者接受最佳的药物治疗,并对其进行为期 12 个月的系统随访。通过单变量和多变量分析研究了 HRMR-VWI 特征与同侧中风复发时间之间的关系:结果:来自 15 个中心的 255 名连续患者被纳入研究。累积 12 个月的同侧复发率为 4.1%(95% 置信区间 [CI]:1.6-6.6%)。同侧中风复发患者的斑块内出血(IPH)(30.0% 对 6.5%)和偏心斑块(90.0% 对 48.2%)发生率较高,而闭塞性血栓发生率较低(10.0% 对 23.7%)。HRMR-VWI显示的斑块长度(5.69±2.21 mm vs. 6.67±4.16 mm)、斑块负荷(78.40±7.37% vs. 78.22±8.32%)、狭窄程度(60.25±18.95% vs. 67.50±22.09%)和重塑指数(1.07±0.27 vs. 1.03±0.35)在复发同侧中风和非复发同侧中风患者之间没有差异。在多变量考克斯回归分析中,IPH(危险比:6.64,95% CI:1.23-35.8,P=0.028)与调整后的复发性同侧卒中显著相关:我们的研究结果表明,IPH 与同侧中风复发密切相关,在选择患者采取积极治疗策略方面具有潜在价值:本研究的数据可根据要求获取。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

Background: 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).

Methods: 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 multiparametric magnetic resonance imaging (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.

Results: 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.Conclusions:Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.

Data access statement: Data from this study are available and can be accessed upon request.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信