The fibrinogen-to-albumin ratio is associated with intracranial atherosclerosis plaque enhancement on contrast-enhanced high-resolution magnetic resonance imaging

Ye Li; Yuxuan Feng; Rui Liu; Meijuan Dang; Tao Li; Lili Zhao; Jialiang Lu; Ziwei Lu; Yang Yang; Xiaoya Wang; Yating Jian; Heying Wang; Wei Huang; Lei Zhang; Guilian Zhang

doi:10.3389/fneur.2023.1153171

The fibrinogen-to-albumin ratio is associated with intracranial atherosclerosis plaque enhancement on contrast-enhanced high-resolution magnetic resonance imaging

Front Neurol. 2023 May 24:14:1153171. doi: 10.3389/fneur.2023.1153171. eCollection 2023.

Authors

Ye Li¹, Yuxuan Feng¹, Rui Liu², Meijuan Dang¹, Tao Li¹, Lili Zhao¹, Jialiang Lu¹, Ziwei Lu¹, Yang Yang¹, Xiaoya Wang¹, Yating Jian¹, Heying Wang¹, Wei Huang³, Lei Zhang¹, Guilian Zhang¹

Affiliations

¹ Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
² Department of Neurology, The First Hospital of Yulin, Yulin, Shaanxi, China.
³ Department of Medical Imaging, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Abstract

Background: Contrast-enhanced high-resolution magnetic resonance imaging (CE-HR-MRI) is a useful imaging modality to assess vulnerable plaques in intracranial atherosclerotic stenosis (ICAS) patients. We studied the relationship between the fibrinogen-to-albumin ratio (FAR) and plaque enhancement in patients with ICAS.

Methods: We retrospectively enrolled consecutive ICAS patients who had undergone CE-HR-MRI. The degree of plaque enhancement on CE-HR-MRI was evaluated both qualitatively and quantitatively. Enrolled patients were classified into no enhancement, mild enhancement, and obvious enhancement groups. An independent association of the FAR with plaque enhancement was identified by multivariate logistic regression and receiver operating characteristic (ROC) curve analyses.

Results: Of the 69 enrolled patients, 40 (58%) were classified into the no/mild enhancement group, and 29 (42%) into the obvious enhancement group. The obvious enhancement group had a significantly higher FAR than the no/mild enhancement group (7.36 vs. 6.05, p = 0.001). After adjusting for potential confounders, the FAR was still significantly independently associated with obvious plaque enhancement in multiple regression analysis (odds ratio: 1.399, 95% confidence interval [CI]: 1.080-1.813; p = 0.011). ROC curve analysis revealed that FAR >6.37 predicted obvious plaque enhancement with 75.86% sensitivity and 67.50% specificity (area under the ROC curve = 0.726, 95% CI: 0.606-0.827, p < 0.001).

Conclusion: The FAR can serve as an independent predictor of the degree of plaque enhancement on CE-HR-MRI in patients with ICAS. Also, as an inflammatory marker, the FAR has potential as a serological biomarker of intracranial atherosclerotic plaque vulnerability.

Keywords: fibrinogen-to-albumin ratio; high-resolution magnetic resonance imaging; inflammation; intracranial atherosclerotic stenosis; plaque enhancement.