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Plaque characteristics and hemodynamics contribute to neurological impairment in patients with ischemic stroke and transient ischemic attack.

Authors
  • Liu, Song1
  • Tang, Ruowei1
  • Xie, Weiwei1
  • Chai, Shengting1
  • Zhang, Qingqing1
  • Luo, Yu2
  • Guo, Yu1
  • Chai, Chao1
  • Huang, Lixiang1
  • Zheng, Meizhu3
  • Zhu, Jinxia4
  • Chang, Binge5
  • Yang, Qi6
  • Jin, Song7
  • Fan, Zhaoyang8
  • Xia, Shuang9
  • 1 Department of Radiology, Tianjin First Central Hospital, No.24 Fukang Road, Nankai District, Tianjin, 300192, China. , (China)
  • 2 Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200081, China. , (China)
  • 3 Department of Radiology, Tianjin Third Central Hospital, Tianjin, 300170, China. , (China)
  • 4 MR Collaboration, Siemens Healthcare Ltd., Beijing, 100102, China. , (China)
  • 5 Department of Neurosurgery, Tianjin First Central Hospital, Tianjin, 300192, China. , (China)
  • 6 Department of Radiology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. , (China)
  • 7 Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300350, China. , (China)
  • 8 Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
  • 9 Department of Radiology, Tianjin First Central Hospital, No.24 Fukang Road, Nankai District, Tianjin, 300192, China. [email protected] , (China)
Type
Published Article
Journal
European Radiology
Publisher
Springer-Verlag
Publication Date
Apr 01, 2021
Volume
31
Issue
4
Pages
2062–2072
Identifiers
DOI: 10.1007/s00330-020-07327-1
PMID: 32997174
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We aimed to investigate differential characteristics of plaque in the middle cerebral artery (MCA) and hemodynamics in patients with ischemic stroke and transient ischemic attack (TIA), and to develop a predictive model for the presence of ischemic stroke and neurological impairment. Sixty-seven patients with acute ischemic events in MCA territory who underwent high-resolution vessel wall imaging between September 2016 and August 2018 were reviewed retrospectively. Patients were assigned to either the stroke group or TIA group, according to diffusion-weighted imaging and neurological examination. Plaque characteristics and anterograde score (AnS) were calculated. Tmax > 6.0-s volume was acquired by RApid Processing of perfusIon and Diffusion software. Multivariate logistic regression analysis and multiple linear regression analysis were performed to establish a predictive model for irreversible infarction occurrence and clinical severity. Forty-five patients were assigned to the stroke group, and 22 were assigned to the TIA group. Plaque length, intraplaque hemorrhage (IPH), enhancement, AnS, and Tmax > 6.0-s volumes were significantly different between the two groups (p < 0.05). IPH and AnS were independent predictors for patients with stroke (p = 0.020 and 0.034, respectively). Tmax > 6.0-s volume, IPH, hypertension, and AnS were associated with high National Institutes of Health Stroke Scale (NIHSS) scores (all p < 0.05, R = 0.725, and adjusted R2 = 0.494). IPH and AnS are useful in predicting stroke occurrence. Tmax > 6.0-s volume, IPH, hypertension, and AnS are associated with neurological impairment of the patients. • Ischemic stroke and TIA patients have different plaque characteristics and hemodynamics. • Intraplaque hemorrhage and anterograde score have high diagnostic efficiency for ischemic stroke. • The combination of Tmax > 6.0-s volume, intraplaque hemorrhage, hypertension, and anterograde score can predict the National Institutes of Health Stroke Scale scores of patients.

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