纤维帽状态或斑块表面形态与斑块内出血量随时间的关系：PARISK研究

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-03-12 DOI:10.1016/j.jstrokecerebrovasdis.2025.108283

Mohamed Kassem , Tahnee Gorissen , Mohammad Albenwan , Juul Bierens , Dianne H.K. van Dam-Nolen , Madieke I. Liem , Paul A.M. Hofman , Joachim E Wildberger , Jeroen Hendrikse , Werner Mess , Paul J. Nederkoorn , Daniel Bos , Patty Nelemans , Robert J. van Oostenbrugge , M. Eline Kooi

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引用次数: 0

摘要

背景：颈动脉斑块内出血（IPH）是中风的一个强有力的预测指标，但导致IPH发展的因素尚不完全清楚。因此，我们研究了薄/破裂的纤维帽(TRFC)/破裂的斑块表面与IPH体积之间的纵向关系。方法116例伴有同侧颈动脉斑块的缺血性TIA/卒中患者接受基线和两年随访MRI检查。评估MRI上的IPH和纤维帽状态（厚vs TRFC）以及CTA上斑块表面的破坏（光滑vs裂隙/溃疡）。结果在TRFC组和斑块表面破坏组中，随访期间中位IPH体积（倾向于）下降（基线：97.3 IQR: [3.2-193.3] mm3，随访：29.7 [0.0-115.1]mm3, p = 0.09；基线：25.1 [0.0-166.2]mm3，随访：11.2 [0.0-68.3]mm3, p = 0.04）。在具有厚纤维帽/光滑斑块表面的组中，基线和随访时的中位IPH体积为零。与纤维帽厚/斑块表面光滑的患者相比，TRFC/斑块破裂组IPH进展的风险更高（风险比（RR）分别为2.9和2.0）。结论：随着时间的推移，伴有TRFC/斑块破裂的tia /卒中患者IPH体积净减少，表明部分患者斑块已愈合，但TRFC/斑块破裂的患者IPH进展的风险仍增加。临床试验注册：clinicaltrials .gov NCT01208025。

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The relationship between fibrous cap status or plaque surface morphology and intraplaque hemorrhage volume over time: The PARISK Study

Background

Carotid intraplaque hemorrhage (IPH) is a strong predictor of stroke, but factors contributing to IPH development are incompletely understood. Therefore, we investigate the longitudinal relationship between a thin/ruptured fibrous cap (TRFC)/disrupted plaque surface and IPH volume.

Methods

116 ischemic TIA/stroke patients with ipsilateral carotid plaques underwent baseline and two-year follow-up MRI. IPH and fibrous cap status (thick versus TRFC) on MRI and disruption of the plaque surface (smooth versus fissure/ulceration) on CTA were assessed.

Results

In the TRFC and disrupted plaque surface groups, the median IPH volume (tended) to decrease during follow-up (baseline: 97.3 IQR: [3.2-193.3] mm³ versus follow-up: 29.7 [0.0-115.1] mm³, p = 0.09, and baseline: 25.1 [0.0-166.2] mm³ versus follow-up: 11.2 [0.0-68.3] mm³, p = 0.04, respectively). In the group with a thick fibrous cap/smooth plaque surface, the median IPH volumes were zero at baseline and follow-up. The risk of IPH progression was higher in the TRFC/disrupted plaque groups (risk ratio (RR): 2.9 and 2.0, respectively) than in patients with a thick fibrous cap/smooth plaque surface.

Conclusion

TIA/stroke patients with a TRFC/disrupted plaque showed a net decrease in IPH volume over time, indicating plaque healing in some patients, but patients with a TRFC/disrupted plaque are still at increased risk for IPH progression.

Trial registration

ClinicalTrials.gov NCT01208025.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.