Predictive Value of HR-MRI Combined with miR-433-5p and D-dimer for Prognosis of Ischemic Stroke
Objective To investigate the predictive value of high-resolution magnetic resonance vascular wall imaging(HR-MRI)combined with miR-433-5p and D-dimer in the prognosis of ischemic stroke.Methods Ischemic stroke patients(group A,80 cases)and middle cerebral artery atherosclerosis non-stroke patients(group B,40 cases)were selected for study.Perform HR-MRI examination to evaluate thin fiber cap and plaque enhancement,record vascular area,luminal area,wall area,narrowest point of blood vessel,as well as reference level vascular area and luminal area,calculate plaque load,plaque area,luminal stenosis rate,remodeling index,and standardized wall index.qPCR detection of serum miR-433-5p expression level,and immunoturbidimetry was used to determine the concentration of D-dimer.According to the follow-up results,patients with mRS≤2 points were included in group with good prognosis,while patients with mRS>2 points were included in group with poor prognosis.Results The proportion of thin fiber caps(P<0.001),plaque enhancement ratio(P<0.001),plaque burden ratio(P<0.01),and lumen stenosis rate(P<0.01)in group A patients were significantly higher than those in group B.The serum miR-433-5p expression level in group A patients was significantly lower than that in group B(P<0.001),and the D-dimer concentration was significantly higher than that in group B(P<0.01).The proportion of thin fiber cap,plaque enhancement,plaque load rate,and luminal stenosis rate in poor prognosis group of ischemic stroke patients were significantly higher than those in good prognosis group(P<0.05).The serum miR-433-5p expression level in patients with ischemic stroke in poor prognosis group was significantly lower than that in good prognosis group(P<0.001),and the D-dimer concentration was significantly higher than that in good prognosis group(P<0.01).ROC curve analysis showed that thin fiber cap,plaque enhancement,plaque load,luminal stenosis rate,miR-433-5p,and D-dimer combination had the highest predictive value for prognosis of ischemic stroke patients(AUC=0.962),followed by miR-433-5p(AUC=0.864),plaque enhancement(AUC=0.835),luminal stenosis rate(AUC=0.802),thin fiber cap(AUC=0.793),D-dimer(AUC=0.778),and plaque load(AUC=0.741).Conclusion The results showed that the parameters of HR-MRI,including thin fiber cap,plaque enhancement,plaque load,luminal stenosis rate,miR-433-5p,D-dimer,were correlated with prognosis of ischemic stroke.The combination of these parameters has high predictive value for prognosis.
ischemic strokehigh resolution magnetic resonance vascular wall imagingmiR-433-5pD-dimerprognostic level
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