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• Clinical Article •
The predictive performance of 3D-HRVWI radiomics features of intracranial arterial culprit plaque combined with intraplaque hemorrhage in predicting recurrence in patients with ischemic stroke
CAO Tingting  PAN Zhaoye  ZHAO Yuwei  FENG Qiuhao  FAN Xian  LU Yu  JIANG Hongbiao  ZHU Li  WANG Tianle 

Cite this article as: CAO T T, PAN Z Y, ZHAO Y W, et al. The predictive performance of 3D-HRVWI radiomics features of intracranial arterial culprit plaque combined with intraplaque hemorrhage in predicting recurrence in patients with ischemic stroke[J]. Chin J Magn Reson Imaging, 2025, 16(3): 24-30, 50. DOI:10.12015/issn.1674-8034.2025.03.004.


[Abstract] Objective To construct a prediction model for recurrence of intracranial atherosclerotic stroke patients by combining the radiomic features of intracranial culprit plaques in three-dimensional high-resolution vessel wall imaging with MRI (3D-HRVWI) and intraplaque hemorrhage (IPH). This can help clinically target targeted interventions for high-risk populations to reduce the risk of future stroke recurrence.Materials and Methods A total of 296 stroke patients who underwent HRVWI examination from November 2021 to August 2023 were retrospectively collected, and the imaging features of culprit plaques were measured in the non-contrast sequence T1WI and enhanced sequence CE-T1WI images of 296 patients, and the plaques were delineated, the radiomics features were extracted, and the feature correlation analysis and feature screening based on L1 regularization (linear models penalized with the L1norm, L1 Based) screened radiomics features, and all data were randomly divided into training group and test group in a 7 : 3 ratio. In the training group, the radiomics features of the screened responsible plaques were used to construct a radiomics model for predicting stroke recurrence, and the radiomics features and IPH were used to construct a combined model, and the performance was evaluated in the test group. The receiver operating curve (ROC) and area under the curve (AUC) were used to evaluate the predictive performance of each model, and the DeLong test was used to compare the differences between AUC, and finally the nomogram visualization model was established.Results The mean age of the participants was 66 years, including 207 male participants (69.9%) and 89 female participants (30.1%), of whom 58 (19.6%) had recurrent stroke. IPH (OR = 8.577, 95% CI: 4.374 to 16.818) was an independent risk factor for stroke recurrence among the clinical features and radiographic features of the culprit plaques. The radiomics features of 2153 culprit plaques were extracted from the CE-T1WI and T1WI sequences, respectively, and after feature screening, 4 radiomics features were retained in the CE-T1WI sequence data and 6 radiomics features were retained in the T1WI sequence data. In the training group, the AUC was 0.757 (0.693 to 0.814) for IPH, 0.770 (0.707 to 0.826) for radiomics features, and 0.866 (0.811 to 0.909) for the combined model. In the test group, the AUC was 0.750 (0.647 to 0.836) for IPH, 0.819 (0.723 to 0.892) for radiomics features, and 0.880 (0.794 to 0.939) for the combined model. The results of DeLong's test showed that the combined model outperformed the IPH model in the training group and the test group (P < 0.05).Conclusions The 3D-HRVWI radiomics features of intracranial culprit plaque combined with IPH have good efficacy in predicting recurrence in patients with intracranial atherosclerotic stroke, which is better than the independent IPH model.
[Keywords] intracranial atherosclerotic disease；high resolution vessel wall image；magnetic resonance imaging；radiomics；intraplaque hemorrhage；recurrence of stroke

CAO Tingting   PAN Zhaoye   ZHAO Yuwei   FENG Qiuhao   FAN Xian   LU Yu   JIANG Hongbiao   ZHU Li   WANG Tianle*  

Department of Radiology, Nantong First People's Hospital, Nantong 226001, China

Corresponding author: WANG T L, E-mail: wangtianle9192@163.com

Conflicts of interest   None.

Received  2024-12-20
Accepted  2025-03-10
DOI: 10.12015/issn.1674-8034.2025.03.004
Cite this article as: CAO T T, PAN Z Y, ZHAO Y W, et al. The predictive performance of 3D-HRVWI radiomics features of intracranial arterial culprit plaque combined with intraplaque hemorrhage in predicting recurrence in patients with ischemic stroke[J]. Chin J Magn Reson Imaging, 2025, 16(3): 24-30, 50. DOI:10.12015/issn.1674-8034.2025.03.004.

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