Prognostic value of high-resolution magnetic resonance imaging in evaluating carotid atherosclerotic plaque in patients with ischemic stroke

Medicine (Baltimore). 2017 Nov;96(45):e8515. doi: 10.1097/MD.0000000000008515.

Abstract

Background: Ischemic stroke (IS) is a devastating occurrence affecting millions worldwide. This study aimed to evaluate the prognostic value of high-resolution magnetic resonance imaging (HRMRI) in assessing carotid atherosclerotic plaque in IS patients.

Methods: Between January 2013 and March 2015, 338 IS patients were recruited for the investigative purposes of the study. All participants of the study underwent an HRMRI inspection procedure after being admitted into the hospital. During this study, we systematically analyzed and measured various types of fibrous caps, lipid compositions, and plaque lipid ratios. Univariate and multivariate logistic regression analyses were performed for predicting prognosis of IS patients. A receiver-operating characteristic (ROC) curve was employed to determine the accuracy of the IS prognosis.

Results: The percentage of type I fibrous caps exhibited significant decrease, while the percentage of type III fibrous caps, lipid compositions, and lipid ratios all displayed increase. The results of the univariate analysis indicated that age, hypertension, hyperlipidemia, treatment regimens, fibrous cap type, plaque type, lipid composition, and lipid ratio shared a correlation in regards to the poor prognosis of IS patients. Multivariate logistic regression analysis demonstrated that the prognosis of IS patients was not necessarily dependent on fibrous cap type, plaque type, or age. ROC curves revealed that the HRMRI possessed a strong predicative ability in relation to the identification of the prognosis of IS patients through factors such as type of plaque and fibrous caps determination.

Conclusion: Our study conclusively intimated the promise of HRMRI as an evaluative tool for the determination of carotid atherosclerotic plaques in patients with IS.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carotid Artery Diseases / pathology*
  • Female
  • Humans
  • Hyperlipidemias / epidemiology
  • Hypertension / epidemiology
  • Lipids / analysis
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / epidemiology
  • Plaque, Atherosclerotic / pathology*
  • Prognosis
  • ROC Curve
  • Stroke / pathology*

Substances

  • Lipids