Journal Article

Quantitative assessment of symptomatic intracranial atherosclerosis and lenticulostriate arteries in recent stroke patients using whole-brain high-resolution cardiovascular magnetic resonance imaging

Yang, Yujiao, Ji, Xunming, Fan, Zhaoyang, Li, Debiao, Yang, Qi, Miao, Huijuan, Wang, Mengnan, Wu, Fang, Guo, Xiuhai

2018

Overview

Background It has been shown that intracranial atherosclerotic stenosis (ICAS) has heterogeneous features in terms of plaque instability and vascular remodeling. Therefore, quantitative information on the changes of intracranial atherosclerosis and lenticulostriate arteries (LSAs) may potentially improve understanding of the pathophysiological mechanisms underlying stroke and may guide the treatment and work-up strategies. Our present study aimed to use a novel whole-brain high-resolution cardiovascular magnetic resonance imaging (WB-HRCMR) to assess both ICAS plaques and LSAs in recent stroke patients. Methods Twenty-nine symptomatic and 23 asymptomatic ICAS patients were enrolled in this study from Jan 2015 through Sep 2017 and all patients underwent WB-HRCMR. Intracranial atherosclerotic plaque burden, plaque enhancement volume, plaque enhancement index, as well as the number and length of LSAs were evaluated in two groups. Enhancement index was calculated as follows: ([Signal intensity (SI) plaque /SI normal wall on post-contrast imaging] − [SI plaque /SI normal wall on matched pre-contrast imaging])/(SI plaque / SI normal wall on matched pre-contrast imaging). Logistic regression analysis was used to investigate the independent high risk plaque and LSAs features associated with stroke. Results Symptomatic ICAS patients exhibited larger enhancement plaque volume (20.70 ± 3.07 mm 3 vs. 6.71 ± 1.87 mm 3 P  = 0.001) and higher enhancement index (0.44 ± 0.08 vs. 0.09 ± 0.06 P  = 0.001) compared with the asymptomatic ICAS. The average length of LSAs in symptomatic ICAS (20.95 ± 0.87 mm) was shorter than in asymptomatic ICAS (24.04 ± 0.95 mm) ( P  = 0.02). Regression analysis showed that the enhancement index (100.43, 95% CI − 4.02-2510.96; P  = 0.005) and the average length of LSAs (0.80, 95% CI − 0.65-0.99; P  = 0.036) were independent factors for predicting of stroke. Conclusion WB-HRCMR enabled the comprehensive quantitative evaluation of intracranial atherosclerotic lesions and perforating arteries. Symptomatic ICAS had distinct plaque characteristics and shorter LSA length compared with asymptomatic ICAS.

• Publisher: BioMed Central,BioMed Central Ltd,Elsevier
• Subject: Adult / Angiology / Arteries / Arteriosclerosis / Asymptomatic Diseases / Atherosclerosis / Basal Ganglia Cerebrovascular Disease - complications / Basal Ganglia Cerebrovascular Disease - diagnostic imaging / Brain / Cardiology / CAT scans / Causes of / Cerebral Arteries - diagnostic imaging / Complications and side effects / Disease / Female / High resolution / High-resolution cardiovascular magnetic resonance imaging / Humans / Image resolution / Imaging / Intracranial Arteriosclerosis - complications / Intracranial Arteriosclerosis - diagnostic imaging / Intracranial atherosclerotic stenosis / Lenticulostriate arteries / Lesions / Magnetic resonance imaging / Magnetic Resonance Imaging - methods / Male / Medical imaging / Medicine / Medicine & Public Health / Middle Aged / Neuroimaging / NMR / Nuclear magnetic resonance / Patients / Perforating / Plaque, Atherosclerotic / Plaques / Predictive Value of Tests / Prognosis / Quantitative analysis / Radiology / Regression analysis / Risk Assessment / Risk Factors / Severity of Illness Index / Stability / Stenosis / Stroke / Stroke - diagnostic imaging / Stroke - etiology / Veins & arteries / Visualization