Different risk factors in identical features of intracranial atherosclerosis plaques in the posterior and anterior circulation in high-resolution MRI

Ziqi Xu; Mingyao Li; Jinhao Lyu; Zhikai Hou; Jianfeng He; Dapeng Mo; Feng Gao; Xin Liu; Binbin Sui; Mi Shen; Yuesong Pan; Yongjun Wang; Xin Lou; Zhongrong Miao; Benyan Luo; Ning Ma

doi:10.1177/1756286420909991

Different risk factors in identical features of intracranial atherosclerosis plaques in the posterior and anterior circulation in high-resolution MRI

Ther Adv Neurol Disord. 2020 Mar 13:13:1756286420909991. doi: 10.1177/1756286420909991. eCollection 2020.

Authors

Ziqi Xu¹, Mingyao Li², Jinhao Lyu³, Zhikai Hou², Jianfeng He³, Dapeng Mo², Feng Gao², Xin Liu⁴, Binbin Sui⁵, Mi Shen⁵, Yuesong Pan⁶, Yongjun Wang⁶, Xin Lou³, Zhongrong Miao², Benyan Luo⁷, Ning Ma⁸

Affiliations

¹ Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
² Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
³ Department of Radiology, Chinese PLA General Hospital, Beijing, China.
⁴ Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
⁵ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
⁶ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
⁷ Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No.79 Qingchun Road, Hangzhou, 310003, China.
⁸ Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, No.119 Nansihuanxilu, Fengtai District, Beijing 100070, China.

Abstract

Background: We constructed a high-volume registry to identify whether risk factors of intracranial atherosclerotic plaque (ICAP) features differ in the posterior and anterior circulation in patients with symptomatic intracranial atherosclerotic stenosis (ICAS) investigated by high-resolution magnetic resonance imaging (HRMRI).

Methods: The registry was constructed for patients with symptomatic ICAS who underwent HRMRI for culprit plaques. ICAP-vulnerable features included positive remodelling, diffuse distribution, intraplaque haemorrhage and strong enhancement.

Results: We analysed risk factors for the same ICAP features between the posterior and anterior circulation in data of 97 patients in the posterior circulation and 105 patients in the anterior circulation ICAPs. In patients with diffuse distribution, the probability of being female were lower [odds ratio (OR):0.08; 95% confidence interval (CI):0.02-0.34; p = 0.001] and having diabetes mellitus was higher (OR: 7.75; 95% CI:1.75-34.39; p = 0.007) in posterior circulation patients. In patients with strong enhancement, the probability of having diabetes was higher in posterior circulation patients (OR:6.71; 95% CI:1.37-32.81; p = 0.019).

Conclusions: Our results demonstrate more risk factors in the posterior than in the anterior circulation in patients with the same ICAP-vulnerable features, highlighting the need for stratification of risk factors in symptomatic ICAPs.

Trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02705599.

Keywords: high resolution MRI; intracranial atherosclerosis plaque; location; risk factors.

Associated data

ClinicalTrials.gov/NCT02705599