Hyperintense Plaque on Intracranial Vessel Wall Magnetic Resonance Imaging as a Predictor of Artery-to-Artery Embolic Infarction. Issue 4 (April 2018)

• Record Type: Journal Article
• Authors: Wu, Fang; Song, Haiqing; Ma, Qingfeng; Xiao, Jiayu; Jiang, Tao; Huang, Xiaoqin; Bi, Xiaoming; Guo, Xiuhai; Li, Debiao; Yang, Qi; Ji, Xunming; Fan, Zhaoyang; Yu, Huan; Cui, Bin; Sun, Jiayu; Sun, Bin; Xia, Shuang; Han, Tong; Cheng, Jingliang
• Is Part Of: Stroke. Volume 49:Issue 4(2018)
• Publication Date: 2018-04
• Subjects: atherosclerosis -- embolism -- magnetic resonance imaging -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.117.020046
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: The aim of the present study was to investigate atherosclerotic plaque characteristics in patients with artery-to-artery (A-to-A) embolic infarction by whole-brain high-resolution magnetic resonance imaging. Methods—: Seventy-four patients (mean age, 54.7±12.1 years; 59 men) with recent stroke in the territory of middle cerebral artery because of intracranial atherosclerotic disease were prospectively enrolled. Whole-brain high-resolution magnetic resonance imaging was performed in all the patients both precontrast and postcontrast administration by using a 3-dimensional T1-weighted vessel wall magnetic resonance imaging technique known as inversion-recovery prepared sampling perfection with application-optimized contrast using different flip angle evolutions. Patients were divided into A-to-A embolic infarction and non–A-to-A embolic infarction groups based on diffusion-weighted imaging findings. The characteristics of the intracranial atherosclerotic plaques were compared between groups. Results—: A total of 74 intracranial atherosclerotic plaques were analyzed (36 in A-to-A embolism group and 38 in non–A-to-A embolism group). Hyperintense plaques (HIPs) were more frequently observed in A-to-A embolism group (75.0% versus 21.1%; P <0.001). Eighteen of the 27 HIPs (66.7%) demonstrated hyperintense spots or areas located adjacent to the lumen versus 9 HIPs (33.3%) located within the plaque in A-to-A embolism group. Furthermore, a higher prevalence of plaque surface irregularity was also observed in A-to-A embolism group (41.7% versus 18.4%; P =0.029). Logistic regression analysis showed that HIP was the most powerful independent predictor of A-to-A embolic infarction ( P <0.001), with the odds ratio of 11.2 (95% confidence interval, 3.5–36.2). Conclusions—: A-to-A embolic infarction has distinct vulnerable plaque characteristics compared with non–A-to-A embolic infarction. HIP and plaque surface irregularity may predict A-to-A embolic infarction.