Intracranial atherosclerotic plaque enhancement associated with ischemic stroke: a study with three-dimensional high-resolution magnetic resonance vessel wall imaging / 复旦学报（医学版）

ABSTRACT

Objective To evaluate the reproducibility of three-dimensional high-resolution magnetic resonance imaging (HR-MRI) for vessel wall in demonstration of intracranial atherosclerotic plaque enhancement and to explore the relationship between plaque enhancement and ischemic stroke.Methods Fifty-two patients with ischemic stroke underwent traditional head MRI,three-dimensional time of flight magnetic resonance angiography and HR-MRI on a 3.0 T MRI scanner.Each identified intracranial plaque was classified as either culprit (the only or most stenotic lesion upstream from a stroke) or non-culprit (not the most stenotic lesion upstream from a stroke or not within the vascular territory of a stroke).The degree of plaque enhancement was graded by two independent radiologists.The degree of plaque enhancement and luminal stenosis were compared between the culprit group and the non-culprit group by using Mann-Whitney U test.Binary logistic regression analysis was performed to assess the relation between the degree of plaque enhancement and culprit plaques.Results Total 118 plaques were identified in 52 patients with ischemic stroke (52 culprit plaques and 66 non-culprit plaques).The degree of enhancement was rated as strong,moderate and none in 40,9 and 3 culprit plaques,and in 4,24 and 38 non-culprit plaques.Both intra-observer and inter-observer agreement were high for identification of plaque enhancement (kappa＞ 0.75).For culprit plaques group,the degree of plaque enhancement(Z =-7.787,P＜0.01) and luminal stenosis (Z =-5.327,P＜0.01) were significantly higher than those in the non-culprit group.Binary logistic regression analysis revealed that strong enhancement of plaques was independently associated with culprit plaques (OR74.3,95％CI15.0-367.1,P＜0.01).Conclusions Three-dimensional HR-MRI detects enhancement of intracranial plaques with high reproducibility.Enhancement is more common in culprit plaques and is associated with the likelihood of ischemic stroke.