Combination of Plaque Characteristics, Pial Collaterals, and Hypertension Contributes to Misery Perfusion in Patients With Symptomatic Middle Cerebral Artery Stenosis
机构：[1]Radiology Department, First Central Clinical College, Tianjin Medical University, Tianjin, China[2]Radiology Department, Tianjin First Central Hospital, Tianjin, China[3]Radiology Department, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s HospitalAffiliated to Tongji University School ofMedicine, Shanghai, China[4]Neurosurgery Department, Tianjin First Central Hospital, Tianjin, China[5]Radiology Department, Xuanwu Hospital, Capital Medical University, Beijing, China放射科首都医科大学宣武医院[6]Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, California, Los Angeles, USA
Background: Atherosclerotic plaque in the middle cerebral artery (MCA) is linked to ischemic stroke events, but the relationship between plaque characteristics and cerebral perfusion is unclear. Purpose: To investigate MCA plaque characteristics between intracranial atherosclerotic patients with and without hypoperfusion area, and to identify the variables affecting hypoperfusion volume. Study Type: Retrospective. Population: Seventy-one patients with MCA stenosis (>50%), and all with ischemic onset in recent 2 weeks. Field Strength/Sequence: 3.0T MRI / diffusion-weighted imaging (DWI), time-of-flight magnetic resonance angiography (TOF-MRA), inversion-recovery prepared sampling perfection with application-optimized contrast using different flip angle evolutions (IR-SPACE), dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI). Assessment: Plaque characteristics including eccentric index (EI), eccentricity, plaque length, and enhancement on MCA were measured on IR-SPACE. Pial collaterals (PCs) were evaluated on axial TOF-MRA source images. Time-to-maximum (Tmax) maps with a threshold more than 6 seconds were assessed by rapid processing of perfusion and diffusion (RAPID) software. Statistical Tests: Two independent-samples t-tests, Mann–Whitney U-test, chi-square test, Z test, univariate and multivariate logistic analysis, and receiver operating characteristic (ROC) curve were used. Results: Patients with hypoperfusion had fewer eccentric plaque, lower EI, longer plaque length, and poor PCs compared with those without (P = 0.002, 0.016, 0.003, and 0.001). Eccentricity, plaque length, PCs, and hypertension were the factors independently associated with the occurrence of hypoperfusion after adjustment for risk factors of cerebrovascular disease (P = 0.014, 0.017, 0.035, and 0.018). The area under the curve (AUC) (95% confidence interval) was 0.865 (0.763–0.934) for a combination of the above four variables, which was significantly higher than any variable alone (P < 0.001, 0.016, < 0.001, and < 0.001). Patients with lower EI, concentric morphology, and grade 2 enhancement trended to have larger hypoperfusion volume (P = 0.028, 0.037, and 0.009). Data Conclusion: Plaque eccentricity, plaque length, PCs, and hypertension showed an association with the occurrence of hypoperfusion. Level of Evidence: 4. Technical Efficacy Stage: 2. J. Magn. Reson. Imaging 2019. ? 2019 International Society for Magnetic Resonance in Medicine
基金：
Natural Scientific Foundation of
China; Contract grant number: 81871342 to S.X.; Contract
grant sponsor: Tianjin Science and Technology Project; Contract
grant number: 16ZXMJSY00210 to S.X.; Contract grant
sponsor: National Institutes of Health; Contract grant number:
NIH/NHLBI 1R01HL47355 to Z.F.; Contract grant sponsor:
Shanghai Health Bureau Science and Research Projects Foundation;
Contract grant number: 201740137 to Y.L.
语种：
外文
中科院(CAS)分区：
出版当年[2018]版：
大类|3 区医学
小类|2 区核医学
最新[2025]版：
大类|2 区医学
小类|3 区核医学
第一作者：
第一作者机构：[1]Radiology Department, First Central Clinical College, Tianjin Medical University, Tianjin, China[2]Radiology Department, Tianjin First Central Hospital, Tianjin, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Radiology, Tianjin First Central Hospital, 24 Fukang Road,Nankai District, Tianjin, China[*2]Department of Neurosurgery, Tianjin First Central Hospital, 24 Fukang Road, Nankai District, Tianjin, China.
推荐引用方式(GB/T 7714)：
Song Liu,Yu Luo,Chen Wang,et al.Combination of Plaque Characteristics, Pial Collaterals, and Hypertension Contributes to Misery Perfusion in Patients With Symptomatic Middle Cerebral Artery Stenosis[J].Journal of Magnetic Resonance Imaging.2019,doi:10.1002/jmri.26778.
APA：
Song Liu,Yu Luo,Chen Wang,Ruowei Tang,Zhiguo Sheng...&Shuang Xia.(2019).Combination of Plaque Characteristics, Pial Collaterals, and Hypertension Contributes to Misery Perfusion in Patients With Symptomatic Middle Cerebral Artery Stenosis.Journal of Magnetic Resonance Imaging,,
MLA：
Song Liu,et al."Combination of Plaque Characteristics, Pial Collaterals, and Hypertension Contributes to Misery Perfusion in Patients With Symptomatic Middle Cerebral Artery Stenosis".Journal of Magnetic Resonance Imaging .(2019)
