Key result
Intraplaque hemorrhage (OR 5.248) and greater plaque burden (OR 1.136) were independent predictors of multiple infarcts in patients with middle cerebral artery atherosclerosis.
Why the study?
Understanding the stroke mechanism of middle cerebral artery atherosclerosis may inform secondary prevention by clarifying the relationship between vascular wall characteristics and infarction patterns.
Does high-resolution MRI plaque characterization predict multiple versus single infarction patterns in patients with acute ischemic stroke due to MCA atherosclerosis?
Observational (n=92)
Does high-resolution MRI plaque characterization predict multiple versus single infarction patterns in patients with acute ischemic stroke due to MCA atherosclerosis?
Odds Ratio: 5.248 (95% CI 1.573–17.512)
p-value: p=0.007
Intraplaque hemorrhage and greater plaque burden on high-resolution MRI are independently associated with multiple infarcts in patients with middle cerebral artery atherosclerosis.
May refine MCA atherosclerosis risk stratification; hypothesis-generating for tailored prevention pending prospective validation.
Background and purpose Understanding the stroke mechanism of middle cerebral artery (MCA) atherosclerosis may inform secondary prevention. The aim of this study was to explore the relationship between vascular wall characteristics and infarction patterns using high-resolution magnetic resonance imaging (HRMRI) and diffusion-weighted imaging (DWI). Methods From November 2018 to March 2021, patients with acute ischemic stroke due to MCA atherosclerotic disease were retrospectively analyzed. The wall characteristics of atherosclerotic MCA, including conventional characteristics and histogram-defined characteristics, were evaluated using HRMRI. Patients were divided into single-infarction and multiple-infarction groups based on DWI, and wall characteristics were compared between the two groups. Results Of 92 patients with MCA plaques, 59 patients (64.1%) had multiple infarcts, and 33 (35.9%) had single infarcts. The histogram-defined characteristics showed no differences between the single-infarction and multiple-infarction groups ( P >0.05). Plaque burden, degree of stenosis, and prevalence of intraplaque hemorrhage (IPH) were significantly greater in the multiple-infarction group than in the single-infarction group (plaque burden: P = 0.001; degree of stenosis: P = 0.010; IPH: P = 0.019). Multivariate analysis showed that plaque burden (odds ratio: 1.136; 95% confidence interval: 1.054–1.224, P = 0.001) and IPH (odds ratio: 5.248; 95% confidence interval: 1.573–17.512, P = 0.007) were independent predictors for multiple infarction. Conclusion IPH and plaque burden are independently associated with multiple infarcts. HRMRI may provide new insight into the mechanisms underlying the different MCA infarction patterns.
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Ma et al. (2022) conducted an observational in Acute ischemic stroke due to middle cerebral artery atherosclerosis (n=92). Intraplaque hemorrhage vs. Absence of intraplaque hemorrhage was evaluated on Multiple infarction pattern on diffusion-weighted imaging (OR 5.248, 95% CI 1.573-17.512, p=0.007). Intraplaque hemorrhage (OR 5.248) and greater plaque burden (OR 1.136) were independent predictors of multiple infarcts in patients with middle cerebral artery atherosclerosis.
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