The remodeling index of high-resolution magnetic resonance vessel wall imaging before endovascular therapy predicts intracranial atherosclerotic stroke caused by large vessel occlusion
Objective To investigate the predictive value of high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)features for the etiology of acute ischemic stroke(AIS)caused by intracranial large vessel occlusion(LVO).Methods Patients diagnosed with AIS caused by LVO at the Affiliated Hospital of Yangzhou University from August 1,2019 to August 1,2022 were retrospectively collected.All patients underwent HRMR-VWI evaluation and endovascular treatment between 4.5 and 24 hours after onset.Complete recanalization of occluded vessels after direct aspiration first-pass was defined as embolic LVO,and those with residual stenosis＞50％after the direct aspiration first-pass were classified as intracranial atherosclerotic stenosis related LVO(ICAS-LVO).Results A total of 28 patients were included.Their age was 65.32±2.23 years,20(71.4％)were males.There were 22 patients(78.6％)in the embo-LVO group and 6(21.4％)in the ICAS-LVO group.Multivariate logistic regression analysis showed that the remodeling index was an independent predictor of ICAS-LVO(odds ratio 1.081,95％confidence interval 1.001-1.167;P=0.046).The receiver operating characteristic curve analysis showed that the area under the curve of the remodeling index for predicting ICAS-LVO was 0.882(95％confidence interval 0.724-1.00;P=0.003).The optimal cutoff value was 1.1,and the predictive sensitivity and specificity were 66.7％and 100.0％,respectively.Conclusions The HRMR-VWI remodeling index is an independent predictor of ICAS-LVO,with a remodeling index ≥1.1 indicating ICAS-LVO.HRMR-VWI can help identify the etiology of patients with AIS caused by LVO,thereby guiding endovascular treatment.
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