Intracranial plaque enhancement ratio (HR 1.62), intraplaque hemorrhage (HR 2.55), and extracranial Plaque-RADS (HR 2.23) predicted stroke recurrence with a combined AUC of 0.79.
Does the combination of intracranial plaque characteristics and extracranial carotid Plaque-RADS predict stroke recurrence in patients with intracranial atherosclerotic ischemic stroke?
The combination of intracranial plaque characteristics and extracranial carotid Plaque-RADS on high-resolution vessel wall imaging is significantly associated with ischemic stroke recurrence.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background In addition to intracranial plaques, extracranial carotid plaques have also been linked to stroke recurrence. However, the association of combined intracranial and extracranial plaque characteristics with stroke recurrence remains unclear. Purpose To evaluate the association between intracranial plaque features and extracranial carotid Plaque Reporting and Data System (Plaque‐RADS) with stroke recurrence utilizing high‐resolution vessel wall imaging (HR‐VWI). Study Type Retrospective. Population The 388 intracranial atherosclerotic ischemic stroke patients (mean age, 57.3 ± 11.5 years, 274 males). Field Strength/Sequence 3T, three‐dimensional T1 weighted 3D fast spin echo. Assessment HR‐VWI was performed in all patients within 7 days of the stroke onset. The imaging features assessed included intracranial plaque characteristics (degree of stenosis, plaque burden, enhancement ratio, remodeling index, and intraplaque hemorrhage IPH) and extracranial carotid Plaque‐RADS. Patients enrolled between May 2022 and July 2024 were included in the study. All patients were followed for a minimum of 12 months. Statistical Tests Mann–Whitney U test or χ 2 test, univariate and multivariate Cox regression analyses, time‐dependent ROC and AUC curves, and Kaplan–Meier survival curves. p ‐values less than 0.05 were regarded as statistically significant. Results During a median follow‐up period of 24 months, 55 patients experienced recurrent stroke. Intracranial plaque enhancement ratio (HR, 1.62; 95% CI, 1.11–2.38), IPH (HR, 2.55; 95% CI, 1.47–4.40), and extracranial carotid Plaque‐RADS (HR, 2.23; 95% CI, 1.29–3.86) were significantly associated with stroke recurrence. Time‐dependent ROC indicated that the maximum AUCs for enhancement ratio, IPH, and Plaque‐RADS were 0.75, 0.69, and 0.68, respectively, while the Cox model including all three reached a maximum AUC of 0.79. Data Conclusion The combination of intracranial plaque characteristics and extracranial carotid Plaque‐RADS can be used to assess ischemic stroke recurrence. Evidence Level 3. Technical Efficacy Stage 2.
Zheng et al. (Fri,) reported a other. Intracranial plaque enhancement ratio (HR 1.62), intraplaque hemorrhage (HR 2.55), and extracranial Plaque-RADS (HR 2.23) predicted stroke recurrence with a combined AUC of 0.79.