A correlation analysis of acute stroke and HRMR-VWI signs of vulnerable carotid plaque

WANG Aijie; HE Yifan; ZHANG Shaoqin; HUANG Ranran; DONG Shengjie; WANG Chunye; ZHANG Guowei

Abstract：Objective To explore the correlation between the MR characteristics of vulnerable carotid artery plaques and acute ischemic stroke by High-resolution magnetic resonance vessel wall imaging(HRMR-VWI).Methods The patients who underwent HRMR-VWI examination due to cerebral ischemia in one limb were retrospectively analyzed.A total of 77 patients with acute ischemic stroke(ACI)and transient ischemic attack(TIA)were screened for vulnerable plaques at the beginning of the responsible internal carotid artery(ICA).Among them,there were 37 patients with ACI and 40 patients with TIA.Regres-sion analysis,variable screening analysis and risk assessment were performed on HRMR-VWI morphology,plaque components,clinical data and risk factors of ICA-vulnerable plaques in patients with ACI and TIA,and a prediction and evaluation model was constructed.Results The diameter of lumen at the narrowest point in ACI patients was smaller than that in TIA patients,and the degree of stenosis was larger than that in TIA patients.The plaque composition of ACI patients showed more fibrous cap de-fect,intra-plaque hemorrhage and enhancement than TIA patients.And,all the differences were statistically significant(P<0.05).The risk factors screened by LASSO regression were as follows:sex,normal vessel diameter distal to plaque,defection of fiber cap,intra-plaque hemorrhage,enhancement,coronary heart disease and smoking history.LASSO-Logistic regression model showed that gender(OR=6.1,95%CI:1.3～31.9),normal vessel diameter distal to plaque(OR=0.3,95%CI:0.1～0.8),defection of fiber cap(OR=14.0,95%CI:2.1～92.6),intra-plaque enhancement(OR=5.8,95%CI:1.31～25.4)were significant risk factors for ACI,and the area under the curve assessed by this model was 0.8649(95%CI:0.7846～0.9452,P<0.001).Conclusion ICA vulnerable plaques in male patients have fiber cap defect,plaque enhancement,and the smaller the diameter of normal vessels distal to plaque,the greater the risk of ICA-related acute stroke in the brain,which provides an objective basis for predicting the occurrence of ACI by HRMR-VWI imaging.