Abstract 12005: Intracranial Plaque Enhancement From High Resolution MR and Future Stroke Recurrence
Background & Objectives: Intracranial atherosclerosis is associated with frequent ischemic stroke recurrence. High resolution magnetic resonance imaging (HRMR) can provide intracranial atheroma information which can be used to predict vulnerability. We performed HRMR in stroke patients with intracranial atherosclerosis to determine whether plaque characteristics from vessel wall image can predict future stroke recurrence.
Methods: Between August 2010 and January 2013, those acute cerebral infarction patients with intracranial atherosclerosis were enrolled and 3-T high resolution vessel wall MR imaging was performed in the relevant intracranial artery. The plaque enhancement was visually determined on T1 weighted image after gadolinium injection. We evaluated initial clinical and laboratory variables. Follow up clinical information for any focal neurological symptom occurrence including cerebral infarction and transient ischemic attack was obtained after index stroke.
Results: Total of 112 patients was included and followed with median of 9 months. Plaque enhancement was detected in 87 patients, and 23 patients experienced stroke recurrence (26.4%) (Figure A, B, C). Among 35 stroke patients without plaque enhancement, 4 patients (11.4%) experienced stroke recurrence. Kaplan-Meyer curves demonstrated a significantly low event free survival in patients with plaque enhancement than in patients without (log-rank test, p=0.034, Figure D). Cox-regression analysis showed that the plaque enhancement from HRMR was associated with marginal increase of stroke recurrence (hazard ratio 2.827; 95% confidence interval 0.959-8.335; p=0.060).
Conclusion: Intracranial plaque enhancement from HRMR is associated with future stroke recurrence among patients with intracranial atherosclerosis. Longer follow up study will delineate clinical significance of HRMR in prediction of stroke recurrence.
- © 2013 by American Heart Association, Inc.