Correlation between atherosclerotic plaque characteristics of mild-to-moderate stenotic middle cerebral artery and ischemic stroke responsible plaque
Objective To analyze the characteristics of atherosclerotic plaques that lead to mild to moderate narrowing in the middle cerebral artery,utilizing high-resolution magnetic resonance imaging of the vascular wall(VW-HRMRI),and explore the connection between these characteristics and the formation of culprit plaques,in addition to their clinical diagnostic significance.Methods A retrospective analysis was performed on both symptomatic(n=33)and asymptomatic(n=19)patients experiencing mild to moderate stenosis of the middle cerebral artery at Xuzhou Central Hospital.VW-HRMRI was employed to examine each patient,resulting in the identification of 68 plaques.These plaques were then classified into two categories:those deemed to be culprit plaques(n=33)and those identified as non-culprit plaques(n=35).Binary Logistic regression analysis and ROC curve analysis were applied to determine the relationship between the characteristics of these plaques and the risk of ischemic stroke,as well as their clinical diagnostic relevance.Results Culprit plaques were identified by notably higher remodeling indices(P=0.03),enhancement grades(P=0.01),volumes(P=0.003),and slopes(P=0.002)in comparison to non-culprit plaques.Logistic regression analysis showed that positive remodeling(OR=5.400,95%CI:1.334-21.857),enhancement grade(OR=4.431,95%CI:1.750-11.219),plaque volume(OR=1.09,95%CI:1.004-1.171),and slope(OR=1.112,95%CI:1.038-1.214)were independently associated with the occurrence of culprit plaques.The AUC for the four risk factors,which include positive remodeling,enhancement grade,plaque volume,and slope,was measured at 0.631,0.696,0.705 and 0.693.Subsequently,the predictive model that integrates these risk factors reached an AUC of 0.875,showing a sensitivity of 0.818 and a specificity of 0.800.Conclusion Positive remodeling,enhancement grade,plaque volume,and slope stand as independent risk factors for culprit plaques.The collective use of these four imaging features significantly enhances the predictive accuracy for identifying culprit plaques,thereby offering crucial imaging-based evidence to support early clinical interventions.
middle cerebral arterymild to moderate stenosismagnetic resonance vessel wallimaging of ischemic strokeresponsible plaque
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维普
