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Open Access 01-12-2023 | Stroke | Original Article

Incremental value of enhanced plaque length for identifying intracranial atherosclerotic culprit plaques: a high-resolution magnetic resonance imaging study

Authors: XiaoQing Cheng, Jia Liu, HongXia Li, JiaLuo Yang, ChangSheng Zhou, BeiBei Zhi, QuanHui Liu, YingLe Li, LuLu Xiao, WuSheng Zhu, GuangMing Lu

Published in: Insights into Imaging | Issue 1/2023

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Abstract

Objectives

Besides plaque enhancement grade, the incremental value of enhancement-related high-resolution MRI features in defining culprit plaques needs further evaluation. This study was focused on assessing whether plaque enhancement features contribute to culprit plaque identification and further risk stratification.

Methods

We retrospectively studied patients who experienced an acute ischaemic stroke and transient ischaemic attack due to intracranial atherosclerosis from 2016 to 2022. The enhancement features included enhancement grade, enhanced length, and enhancement quadrant. Associations between plaque enhancement features and culprit plaques, as well as diagnostic value, were investigated using logistic regression and receiver operating characteristic analyses.

Results

Overall, 287 plaques were identified, of which 231 (80.5%) and 56 (19.5%) were classified as culprit and non-culprit plaques, respectively. Comparison of the pre- and post-enhancement images revealed enhanced length longer than the plaque length in 46.32% of the culprit plaques. Multivariate logistic regression showed that enhanced length longer than plaque length (OR 6.77; 95% CI 2.47–18.51) and grade II enhancement (OR 7.00; 95% CI 1.69–28.93) were independently associated with culprit plaques. The area under the curve value for the combination of stenosis and plaque enhancement grade for the diagnosis of culprit plaques was 0.787, which increased significantly to 0.825 on the addition of enhanced length longer than the plaque length (p = 0.026 for DeLong’s test).

Conclusions

Enhanced length longer than the plaque length and grade II enhancement were independently associated with culprit plaques. The combination of the enhanced plaque features resulted in better culprit plaque identification.

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Title: Incremental value of enhanced plaque length for identifying intracranial atherosclerotic culprit plaques: a high-resolution magnetic resonance imaging study
Authors: XiaoQing Cheng
Jia Liu
HongXia Li
JiaLuo Yang
ChangSheng Zhou
BeiBei Zhi
QuanHui Liu
YingLe Li
LuLu Xiao
WuSheng Zhu
GuangMing Lu
Publication date: 01-12-2023
Publisher: Springer Vienna
Keyword: Stroke
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01449-y

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