Song Liu1, Ruowei Tang1, Weiwei Xie1, Shengting Chai1, Qingqing Zhang1, Yu Luo2, Yu Guo1, Chao Chai1, Lixiang Huang1, Meizhu Zheng3, Jinxia Zhu4, Binge Chang5, Qi Yang6, Song Jin7, Zhaoyang Fan8, Shuang Xia9. 1. Department of Radiology, Tianjin First Central Hospital, No.24 Fukang Road, Nankai District, Tianjin, 300192, 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. 3. Department of Radiology, Tianjin Third Central Hospital, Tianjin, 300170, China. 4. MR Collaboration, Siemens Healthcare Ltd., Beijing, 100102, China. 5. Department of Neurosurgery, Tianjin First Central Hospital, Tianjin, 300192, China. 6. Department of Radiology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. 7. Department of Radiology, Tianjin Huanhu Hospital, Tianjin, 300350, 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. xiashuang77@163.com.
Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. KEY POINTS: • 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.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: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. KEY POINTS: • 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.
Authors: Jun Lee; Manabu Inoue; Michael Mlynash; Sharanpal K Mann; Carlo W Cereda; Michael Ke; Gregory W Albers; Jean M Olivot Journal: Neurology Date: 2017-05-12 Impact factor: 9.910
Authors: Jonathan T Kleinman; Greg Zaharchuk; Michael Mlynash; Alyshia A Ogdie; Matus Straka; Maarten G Lansberg; Neil E Schwartz; Stephanie Kemp; Roland Bammer; Gregory W Albers; Jean-Marc Olivot Journal: Stroke Date: 2012-04-03 Impact factor: 7.914
Authors: C Tanislav; U Grittner; F Fazekas; V Thijs; T Tatlisumak; R Huber; B von Sarnowski; J Putaala; R Schmidt; P Kropp; B Norrving; P Martus; C Gramsch; A K Giese; A Rolfs; C Enzinger Journal: Eur J Neurol Date: 2016-04-23 Impact factor: 6.089
Authors: J Donald Easton; Jeffrey L Saver; Gregory W Albers; Mark J Alberts; Seemant Chaturvedi; Edward Feldmann; Thomas S Hatsukami; Randall T Higashida; S Claiborne Johnston; Chelsea S Kidwell; Helmi L Lutsep; Elaine Miller; Ralph L Sacco Journal: Stroke Date: 2009-05-07 Impact factor: 7.914
Authors: Valery L Feigin; Mohammad H Forouzanfar; Rita Krishnamurthi; George A Mensah; Myles Connor; Derrick A Bennett; Andrew E Moran; Ralph L Sacco; Laurie Anderson; Thomas Truelsen; Martin O'Donnell; Narayanaswamy Venketasubramanian; Suzanne Barker-Collo; Carlene M M Lawes; Wenzhi Wang; Yukito Shinohara; Emma Witt; Majid Ezzati; Mohsen Naghavi; Christopher Murray Journal: Lancet Date: 2014-01-18 Impact factor: 79.321
Authors: Tao Wang; Jichang Luo; Changyi Liu; Bin Yang; Ran Xu; Long Li; Kun Yang; Chao Zhang; Yabing Wang; Yanfei Chen; Peng Gao; Jian Chen; Liqun Jiao; Yan Ma Journal: Front Neurol Date: 2022-04-13 Impact factor: 4.086