Characteristics of patients with enhancing intracranial atherosclerosis and association between plaque enhancement and recent cerebrovascular ischemic events: a high-resolution magnetic resonance imaging study

Abstract

Background Atherosclerotic plaque inflammation is a well-known risk factor for the development of ischemic stroke. Purpose To investigate the characteristics of patients with enhancing intracranial atherosclerosis and the relationship between plaque enhancement and recent cerebrovascular ischemic events by using high-resolution magnetic resonance imaging (HR-MRI). Material and Methods A total of 141 patients (102 men; mean age = 61.1 ± 11.4 years) with intracranial atherosclerotic plaque who underwent HR-MRI were enrolled in this study. The contrast ratio (CR) and contrast enhancement of the plaques were measured. Binary logistic regression was used to estimate the association between plaque enhancement and clinical and plaque characteristics. The relationship between plaque enhancement and recent ischemic events was evaluated by multivariate logistic regression analysis. Results Of 141 patients, plaque enhancement was detected in 80 (56.7%). Compared to patients without plaque enhancement, those with plaque enhancement had significantly lower level of high-density lipoprotein cholesterol, greater maximum plaque length, and more severe luminal stenosis. Luminal stenosis was independently associated with plaque enhancement (odds ratio [OR] = 1.026; 95% confidence interval [CI] = 1.014–1.039). Multivariate regression analysis showed that plaque enhancement was an independent indicator for recent ischemic events after adjusting for confounding factors (OR = 9.521; 95% CI = 4.301–19.900) (all P < 0.05). Conclusion Luminal stenosis is independently associated with plaque enhancement. We observed a strong association between plaque enhancement and recent ischemic events, which suggests that plaque enhancement may serve as an indicator of its instability.