Share：
Share this content in WeChat
X
[Chinese][PDF]882
• Clinical Article •
The correlation between symptomatic carotid atherosclerotic plaques and short-term mRS score after ischemic stroke
WU Jingjing  ZHANG Yating  ZHANG Lin  YIN Xi  SONG Juan  WANG Chengwei 

Cite this article as: WU J J, ZHANG Y T, ZHANG L, et al. The correlation between symptomatic carotid atherosclerotic plaques and short-term mRS score after ischemic stroke[J]. Chin J Magn Reson Imaging, 2024, 15(3): 26-30. DOI:10.12015/issn.1674-8034.2024.03.005.


[Abstract] Objective High resolution magnetic resonance vessel wall imaging (HR-VWI) was used to analyze the correlation between the composition of symptomatic carotid atherosclerotic plaque and the mRS score three months after secondary prevention of stroke in patients with first ischemic stroke, so as to provide a theoretical basis for the prognosis evaluation of such patients.Materials and Methods From November 2022 to June 2023, patients with ischemic stroke symptoms and carotid atherosclerotic plaque on the symptomatic side were recruited in the First Affiliated Hospital of Shihezi University. Patients who meet the inclusion and exclusion criteria and have completed secondary stroke prevention for 3 months will be continuously enrolled in this study and will receive a modified Rankin Scale (mRS) score. Based on the mRS score, the enrolled patients will be divided into a poor prognosis group (mRS≥2) and a good prognosis group (mRS<2). Compare the clinical data, plaque composition on the first HR-VWI examination, and plaque composition three months after secondary stroke prevention between two groups of patients. Analyzing the correlation between different components in plaques and mRS scores.Results A total of 66 patients were included in the group (39 in the poor prognosis group and 27 in the good prognosis group), and there was no statistically significant difference in clinical data between the two groups (P>0.05). In the first examination, the proportion of plaque bleeding in the poor prognosis group was higher than that in the good prognosis group (P<0.05), and the proportion and volume of calcification in plaques in the good prognosis group were higher than those in the poor prognosis group (P<0.05); After 3 months of secondary prevention of stroke, there was no significant difference in the proportion of plaque bleeding between the poor prognosis group and the good prognosis group (P>0.05), while the good prognosis group had a larger proportion and volume of calcification in plaques (P<0.05).Conclusions The calcification and calcification volume in symptomatic carotid atherosclerotic plaques were correlated with the mRS score 3 months after secondary prevention of stroke in patients with first ischemic stroke; HR-VWI at the initial stage of symptoms can provide a theoretical basis for the prognosis evaluation of ischemic stroke patients due to carotid atherosclerotic plaque.
[Keywords] carotid atherosclerotic plaque；ischemic stroke；modified Rankin Scale；high-resolution magnetic resonance vessel wall imaging；magnetic resonance imaging

WU Jingjing   ZHANG Yating   ZHANG Lin   YIN Xi   SONG Juan   WANG Chengwei*  

Department of Magnetic Resonance, the First Affiliated Hospital of Shihezi University, Shihezi 832000, China

Corresponding author: WANG C W, E-mail: 308199733@qq.com

Conflicts of interest   None.

Received  2023-09-09
Accepted  2024-02-05
DOI: 10.12015/issn.1674-8034.2024.03.005
Cite this article as: WU J J, ZHANG Y T, ZHANG L, et al. The correlation between symptomatic carotid atherosclerotic plaques and short-term mRS score after ischemic stroke[J]. Chin J Magn Reson Imaging, 2024, 15(3): 26-30. DOI:10.12015/issn.1674-8034.2024.03.005.

[1]
BONATI L H, JANSEN O, DE BORST G J, et al. Management of atherosclerotic extracranial carotid artery stenosis[J]. Lancet Neurol, 2022, 21(3): 273-283. DOI: 10.1016/S1474-4422(21)00359-8.
[2]
SCHMID S, TSANTILAS P, KNAPPICH C, et al. Age but not sex is associated with higher risk of in-hospital stroke or death after carotid artery stenting in symptomatic and asymptomatic carotid stenosis[J]. J Vasc Surg, 2019, 69(4): 1090-1101. DOI: 10.1016/j.jvs.2018.03.439.
[3]
DESAI S M, JHA R M, LINFANTE I. Collateral circulation augmentation and neuroprotection as adjuvant to mechanical thrombectomy in acute ischemic stroke[J]. Neurology, 2021, 97(20Suppl 2): S178-S184. DOI: 10.1212/WNL.0000000000012809.
[4]
QIAO C, LIU Z, QIE S. The implications of microglial regulation in neuroplasticity-dependent stroke recovery[J/OL]. Biomolecules, 2023, 13(3): 571 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/36979506/. DOI: 10.3390/biom13030571.
[5]
BIR S C, KELLEY R E. Carotid atherosclerotic disease: A systematic review of pathogenesis and management[J]. Brain Circ, 2022, 8(3): 127-136. DOI: 10.4103/bc.bc_36_22.
[6]
WENG S T, LAI Q L, CAI M T, et al. Detecting vulnerable carotid plaque and its component characteristics: Progress in related imaging techniques[J/OL]. Front Neurol, 2022, 13: 982147 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/36188371/. DOI: 10.3389/fneur.2022.982147.
[7]
FERNANDEZ-ALVAREZ V, LINARES-SANCHEZ M, SUAREZ C, et al. Novel imaging-based biomarkers for identifying carotid plaque vulnerability[J/OL]. Biomolecules, 2023, 13(8): 1236 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/37627301/. DOI: 10.3390/biom13081236.
[8]
PORAMBO M E, DEMARCO J K. MR imaging of vulnerable carotid plaque[J]. Cardiovasc Diagn Ther, 2020, 10(4): 1019-1031. DOI: 10.21037/cdt.2020.03.12.
[9]
GEIGER M A, FLUMIGNAN R, SOBREIRA M L, et al. Carotid Plaque Composition and the Importance of Non-Invasive in Imaging Stroke Prevention[J/OL]. Front Cardiovasc Med, 2022, 9: 885483 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/35651908/. DOI: 10.3389/fcvm.2022.885483.
[10]
TAPIS P, EL-KOUSSY M, HEWER E, et al. Plaque vulnerability in patients with high- and moderate-grade carotid stenosis - comparison of plaque features on MRI with histopathological findings[J/OL]. Swiss Med Wkly, 2020, 150: w20174 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/32065837/. DOI: 10.4414/smw.2020.20174.
[11]
FABIANO S, MANCINO S, STEFANINI M, et al. High-resolution multicontrast-weighted MR imaging from human carotid endarterectomy specimens to assess carotid plaque components[J]. Eur Radiol, 2008, 18(12): 2912-2921. DOI: 10.1007/s00330-008-1091-x.
[12]
JIANG P, CHEN Z, HIPPE D S, et al. Association between carotid bifurcation geometry and atherosclerotic plaque vulnerability: A Chinese atherosclerosis risk evaluation study[J]. Arterioscler Thromb Vasc Biol, 2020, 40(5): 1383-1391. DOI: 10.1161/ATVBAHA.119.313830.
[13]
SABA L, SAAM T, JAGER H R, et al. Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications[J]. Lancet Neurol, 2019, 18(6): 559-572. DOI: 10.1016/S1474-4422(19)30035-3.
[14]
DENG F, MU C, YANG L, et al. Carotid plaque magnetic resonance imaging and recurrent stroke risk: A systematic review and meta-analysis[J/OL]. Medicine (Baltimore), 2020, 99(13): e19377 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/32221065/. DOI: 10.1097/MD.0000000000019377.
[15]
GLYMOUR M M, BERKMAN L F, ERTEL K A, et al. Lesion characteristics, NIH stroke scale, and functional recovery after stroke[J]. Am J Phys Med Rehabil, 2007, 86(9): 725-733. DOI: 10.1097/PHM.0b013e31813e0a32.
[16]
CHEN Y F, CHEN Z J, LIN Y Y, et al. Stroke risk study based on deep learning-based magnetic resonance imaging carotid plaque automatic segmentation algorithm[J/OL]. Front Cardiovasc Med, 2023, 10: 1101765 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/36910524/. DOI: 10.3389/fcvm.2023.1101765.
[17]
LI X D, LI M M. A novel nomogram to predict mortality in patients with stroke: a survival analysis based on the MIMIC-Ⅲ clinical database[J/OL]. BMC Med Inform Decis Mak, 2022, 22(1): 92 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/35387672/. DOI: 10.1186/s12911-022-01836-3.
[18]
JAHAN R, SAVER J L, SCHWAMM L H, et al. Association between time to treatment with endovascular reperfusion therapy and outcomes in patients with acute ischemic stroke treated in clinical practice[J]. JAMA, 2019, 322(3): 252-263. DOI: 10.1001/jama.2019.8286.
[19]
KESELMAN B, GDOVINOVA Z, JATUZIS D, et al. Safety and outcomes of intravenous thrombolysis in posterior versus anterior circulation stroke: Results from the safe implementation of treatments in stroke registry and Meta-analysis[J]. Stroke, 2020, 51(3): 876-882. DOI: 10.1161/STROKEAHA.119.027071.
[20]
SAVER J L, CHAISINANUNKUL N, CAMPBELL B, et al. Standardized nomenclature for modified rankin scale global disability outcomes: Consensus recommendations from stroke therapy academic industry roundtable XI[J]. Stroke, 2021, 52(9): 3054-3062. DOI: 10.1161/STROKEAHA.121.034480.
[21]
ZHAO X Q, SUN J, HIPPE D S, et al. Magnetic resonance imaging of intraplaque hemorrhage and plaque lipid content with continued lipid-lowering therapy: Results of a magnetic resonance imaging substudy in AIM-HIGH[J/OL]. Circ Cardiovasc Imaging, 2022, 15(11): e14229 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/36378778/. DOI: 10.1161/CIRCIMAGING.122.014229.
[22]
BAGANHA F, DE JONG R, PETERS E A, et al. Atorvastatin pleiotropically decreases intraplaque angiogenesis and intraplaque haemorrhage by inhibiting ANGPT2 release and VE-Cadherin internalization[J]. Angiogenesis, 2021, 24(3): 567-581. DOI: 10.1007/s10456-021-09767-9.
[23]
ZHANG X G, XUE J, YANG W H, et al. Inflammatory markers as independent predictors for stroke outcomes[J/OL]. Brain Behav, 2021, 11(1): e1922 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/33314753/. DOI: 10.1002/brb3.1922.
[24]
BOULLIER A, BIRD D A, CHANG M K, et al. Scavenger receptors, oxidized LDL, and atherosclerosis[J]. Ann N Y Acad Sci, 2001, 947(1): 214-223. DOI: 10.1111/j.1749-6632.2001.tb03943.x.
[25]
PARMA L, BAGANHA F, QUAX P, et al. Plaque angiogenesis and intraplaque hemorrhage in atherosclerosis[J]. Eur J Pharmacol, 2017, 816: 107-115. DOI: 10.1016/j.ejphar.2017.04.028.
[26]
CHE F, MI D, WANG A, et al. Extracranial carotid plaque hemorrhage predicts ipsilateral stroke recurrence in patients with carotid atherosclerosis - a study based on high-resolution vessel wall imaging MRI[J/OL]. BMC Neurol, 2022, 22(1): 237 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/35764942/. DOI: 10.1186/s12883-022-02758-3.
[27]
JINNOUCHI H, SATO Y, SAKAMOTO A, et al. Calcium deposition within coronary atherosclerotic lesion: Implications for plaque stability[J]. Atherosclerosis, 2020, 306: 85-95. DOI: 10.1016/j.atherosclerosis.2020.05.017.
[28]
SHI X, GAO J, LV Q, et al. Calcification in atherosclerotic plaque vulnerability: Friend or foe?[J/OL]. Front Physiol, 2020, 11: 56 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/32116766/. DOI: 10.3389/fphys.2020.00056.
[29]
LEE S J, LEE I K, JEON J H. Vascular calcification-new insights into its mechanism[J/OL]. Int J Mol Sci, 2020, 21(8): 2685 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/32294899/. DOI: 10.3390/ijms21082685.
[30]
LIU D D, CHU S F, CHEN C, et al. Research progress in stroke-induced immunodepression syndrome (SIDS) and stroke-associated pneumonia (SAP)[J]. Neurochem Int, 2018, 114: 42-54. DOI: 10.1016/j.neuint.2018.01.002.
[31]
NAKAHARA T, DWECK M R, NARULA N, et al. Coronary artery calcification: From mechanism to molecular imaging[J]. JACC Cardiovasc Imaging, 2017, 10(5): 582-593. DOI: 10.1016/j.jcmg.2017.03.005.
[32]
SABA L, NARDI V, CAU R, et al. Carotid artery plaque calcifications: Lessons from histopathology to diagnostic imaging[J]. Stroke, 2022, 53(1): 290-297. DOI: 10.1161/STROKEAHA.121.035692.
[33]
MORI H, TORII S, KUTYNA M, et al. Coronary artery calcification and its progression: What does it really mean?[J]. JACC Cardiovasc Imaging, 2018, 11(1): 127-142. DOI: 10.1016/j.jcmg.2017.10.012.
[34]
DABRAVOLSKI S A, MARKIN A M, ANDREEVA E R, et al. Molecular mechanisms underlying pathological and therapeutic roles of pericytes in atherosclerosis[J/OL]. Int J Mol Sci, 2022, 23(19): 11663 [2023-09-09]. https://pubmed.ncbi.nlm.nih.gov/36232962/. DOI: 10.3390/ijms231911663.

PREV The value of multi-delay arterial spin labeling in the evaluation of cerebral perfusion in patients with severe arterial stenosis or occlusion
NEXT Risk stratification prediction of glioblastoma based on multi-sequence MRI radiomics analysis
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn