Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI.
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Authors
Publication Date
2018-07Journal Title
AJNR Am J Neuroradiol
ISSN
0195-6108
Publisher
American Society of Neuroradiology (ASNR)
Volume
39
Issue
7
Pages
1286-1292
Language
eng
Type
Article
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Zhu, C., Tian, X., Degnan, A., Shi, Z., Zhang, X., Chen, L., Teng, Z., et al. (2018). Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI.. AJNR Am J Neuroradiol, 39 (7), 1286-1292. https://doi.org/10.3174/ajnr.A5676
Abstract
BACKGROUND AND PURPOSE: Intraplaque hemorrhage within intracranial atherosclerotic plaques identified by high-resolution MR imaging has been studied as a potential marker of stroke risk. However, previous studies only examined intracranial arteries with high-grade stenosis (degree of stenosis, >50%). This study aimed to ascertain the clinical relevance of intraplaque hemorrhage in patients with low- and high-grade stenotic basilar artery plaques. MATERIALS AND METHODS: Patients with basilar artery stenosis (n = 126; mean age, 62 ± 10 years; 66 symptomatic and 60 asymptomatic) underwent high-resolution MR imaging. The relationship between imaging findings (intraplaque hemorrhage, contrast enhancement, degree of stenosis, minimal lumen area, and plaque burden) and symptoms was analyzed. RESULTS: Intraplaque hemorrhage was identified in 22 patients (17.5%), including 21 (31.8%) symptomatic patients and 1 (1.7%) asymptomatic patient. Multivariate analysis showed that intraplaque hemorrhage was the strongest independent marker of symptomatic status (odds ratio, 27.5; 95% CI, 3.4-221.5; P = .002). Contrast enhancement was also independently associated with symptomatic status (odds ratio, 9.9; 95% CI, 1.5-23.6; P = .016). Stenosis, minimal lumen area, and plaque burden were not correlated with symptoms (P > .05). Intraplaque hemorrhage was present in both low- and high-grade stenotic basilar arteries (11.3% versus 16.3%, P = .63). Diagnostic performance values of intraplaque hemorrhage for patients with acute/subacute symptomatic stroke were the following: specificity, 98.3%; sensitivity, 31.8%; positive predictive value, 95.5%; and negative predictive value, 56.7%. CONCLUSIONS: Intraplaque hemorrhage is present in both low- and high-grade stenotic basilar artery plaques and is independently associated with symptomatic stroke status. Intraplaque hemorrhage may identify high-risk plaque and provide new insight into the management of patient with stroke without significant stenosis.
Keywords
Aged, Carotid Stenosis, Female, Hemorrhage, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Odds Ratio, Plaque, Atherosclerotic, Sensitivity and Specificity, Stroke, Vertebrobasilar Insufficiency
Identifiers
External DOI: https://doi.org/10.3174/ajnr.A5676
This record's URL: https://www.repository.cam.ac.uk/handle/1810/279656
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