Jiayu Xiao1, Matthew M Padrick2, Tao Jiang3, Shuang Xia4, Fang Wu5, Yu Guo4, Nestor R Gonzalez6, Shujuan Li7, Konrad H Schlick2, Oana M Dumitrascu2, Marcel M Maya8, Marcio A Diniz9, Shlee S Song2, Patrick D Lyden2, Debiao Li1, Qi Yang10, Zhaoyang Fan11. 1. Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA, USA. 2. Department of Neurology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., 6th Floor, Los Angeles, CA, USA. 3. Department of Radiology, Beijing Chaoyang Hospital, No. 8 Gongti Nanlu, Chaoyang District, Beijing, China. 4. Department of Radiology, Tianjin First Central Hospital, No. 24 Fukang Rd, Nankai Qu, Tianjin District, China. 5. Department of Radiology, Xuanwu Hospital, No. 45 Changchun St, Xicheng District, Beijing, China. 6. Department of Neurosurgery, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., #A6600, Los Angeles, CA, USA. 7. Department of Neurology, Beijing Chaoyang Hospital, No. 8 Gongti Nanlu, Chaoyang District, Beijing, China. 8. Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Blvd Taper M-335, Los Angeles, CA, USA. 9. Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 900, Los Angeles, CA, USA. 10. Department of Radiology, Beijing Chaoyang Hospital, No. 8 Gongti Nanlu, Chaoyang District, Beijing, China. Electronic address: yangyangqiqi@gmail.com. 11. Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT 400, Los Angeles, CA, USA; Department of Radiology, University of Southern California, Los Angeles, CA, USA; Department of Radiation Oncology, University of Southern California, Los Angeles, CA, USA. Electronic address: Zhaoyang.Fan@med.usc.edu.
Abstract
BACKGROUND AND AIMS: Intracranial atherosclerotic disease (ICAD) is a major etiologic cause for acute ischemic stroke (AIS) and transient ischemic attack (TIA). The study was designed to investigate if differential morphological features exist in symptomatic atherosclerotic lesions between AIS and TIA patients. METHODS: The culprit plaques from 45 AIS patients and 42 TIA patients were analyzed for the degree of stenosis, vessel wall irregularity, normalized wall index (NWI), remodeling index, plaque-wall contrast ratio (CR), high signal intensity on T1-weighted images, plaque enhancement ratio and enhancement grade. These plaque features along with clinical characteristics were compared between AIS and TIA groups as well as between their stenosis degree-matched subgroups. RESULTS: Overall, grade 2 enhancement (OR 3.85, 95%CI 1.42-10.46, p = 0.006) and hyperlipidemia (OR 3.04, 95%CI 1.13-8.22, p = 0.025) were independent indicators for AIS, whereas high NWI (OR 1.47, 95%CI 0.76-2.86, p = 0.004) was associated with TIA. In the comparison between the subgroups with moderate (30%-69%) stenosis, high plaque-wall CR (OR 5.38, 95%CI 1.39-20.75, p = 0.008) was associated with AIS, whereas high NWI (OR 2.50, 95%CI 0.61-10.00, p = 0.006) was associated with TIA. CONCLUSIONS: Our study reveals differential morphological features in symptomatic ICAD lesions between AIS and TIA patients. Probing these features with MR vessel wall imaging may provide insights into the prognosis of patients with ICAD.
BACKGROUND AND AIMS: Intracranial atherosclerotic disease (ICAD) is a major etiologic cause for acute ischemic stroke (AIS) and transient ischemic attack (TIA). The study was designed to investigate if differential morphological features exist in symptomatic atherosclerotic lesions between AIS and TIA patients. METHODS: The culprit plaques from 45 AIS patients and 42 TIA patients were analyzed for the degree of stenosis, vessel wall irregularity, normalized wall index (NWI), remodeling index, plaque-wall contrast ratio (CR), high signal intensity on T1-weighted images, plaque enhancement ratio and enhancement grade. These plaque features along with clinical characteristics were compared between AIS and TIA groups as well as between their stenosis degree-matched subgroups. RESULTS: Overall, grade 2 enhancement (OR 3.85, 95%CI 1.42-10.46, p = 0.006) and hyperlipidemia (OR 3.04, 95%CI 1.13-8.22, p = 0.025) were independent indicators for AIS, whereas high NWI (OR 1.47, 95%CI 0.76-2.86, p = 0.004) was associated with TIA. In the comparison between the subgroups with moderate (30%-69%) stenosis, high plaque-wall CR (OR 5.38, 95%CI 1.39-20.75, p = 0.008) was associated with AIS, whereas high NWI (OR 2.50, 95%CI 0.61-10.00, p = 0.006) was associated with TIA. CONCLUSIONS: Our study reveals differential morphological features in symptomatic ICAD lesions between AIS and TIA patients. Probing these features with MR vessel wall imaging may provide insights into the prognosis of patients with ICAD.
Authors: Ye Qiao; Zeeshan Anwar; Jarunee Intrapiromkul; Li Liu; Steven R Zeiler; Richard Leigh; Yiyi Zhang; Eliseo Guallar; Bruce A Wasserman Journal: Stroke Date: 2016-01-07 Impact factor: 7.914