Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging

Objectives: Follow-up observation of changes in intracranial plaques and lenticulostriate arteries (LSAs) under the standard medical treatment can help further observe treatment effects. This study aims to observe the changes in symptomatic intracranial atherosclerosis plaques and LSAs under convent...

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Main Authors: Huijuan Miao, Leticia Simo, Liying Guo, Huimin Fan, Pan Gu, Zhaohui Song, Xiaokun Geng, Yuchuan Ding
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Environmental Disease
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Online Access:https://journals.lww.com/10.4103/ed.ed_15_24
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author Huijuan Miao
Leticia Simo
Liying Guo
Huimin Fan
Pan Gu
Zhaohui Song
Xiaokun Geng
Yuchuan Ding
author_facet Huijuan Miao
Leticia Simo
Liying Guo
Huimin Fan
Pan Gu
Zhaohui Song
Xiaokun Geng
Yuchuan Ding
author_sort Huijuan Miao
collection DOAJ
description Objectives: Follow-up observation of changes in intracranial plaques and lenticulostriate arteries (LSAs) under the standard medical treatment can help further observe treatment effects. This study aims to observe the changes in symptomatic intracranial atherosclerosis plaques and LSAs under conventional medical treatment using high-resolution magnetic resonance imaging (HR-MRI). Subjects and Methods: Thirty-eight symptomatic middle cerebral artery stenotic patients were consecutively enrolled from October 2016 to July 2018 and HR-MRI was performed within the two weeks of the onset of acute ischemic stroke. All patients received standard medical treatment, and HR-MRI was performed at 6 months and 12 months, respectively. The characteristics of plaques and LSAs quantitative analyzed were compared before and after medical treatment. Further analysis was conducted between the subgroups of low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L and LDL-C ≥1.8 mmol/L to explore whether a lower LDL-C level is more closely associated with improvement. Results: Ultimately, 23 patients completed the first examination, and among them, 8 patients completed the second examination. After an average of 8.3 months of treatment in 23 patients, the remodeling index (1.26 ± 0.22 vs. 1.14 ± 0.16, P = 0.008), plaque volume (58.92 ± 26.61 mm3 vs. 42.26 ± 19.60 mm3, P = 0.001), plaque burden (88.29 ± 5.88% vs. 83.42 ± 11.04%, P = 0.033, enhancement volume (20.29 [16.44, 28.59] mm3 vs. 12.00 [0.00, 18.13] mm3, P = 0.000), and enhancement index (EI,0.98 ± 0.44 vs. 0.61 ± 0.48, P = 0.000) were significantly decreased compared to baseline. Repeated-measures analysis of variance showed that only the EI (P = 0.019) and the contrast of signal intensity-based on the pituitary funnel (P = 0.035) exhibited statistically significant differences among these groups. A significant difference in PB (P = 0.01) was observed between the two LDL-C subgroups. Conclusions: HR-MRI can help evaluate the medical effects, different kinds of changes on culprit plaques indicate the effectiveness of standard medical treatment. While standard medical treatment can promote the stability of plaques, the relationship between treatment and changes in LSAs remains unclear. Trial Registration: http://www.clinicaltrials.gov (identifier: NCT02719652).
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spelling doaj-art-0fc3f317b5a34a4591d19bdedfc00f4d2025-08-20T02:08:43ZengWolters Kluwer Medknow PublicationsEnvironmental Disease2468-57042025-01-01101152610.4103/ed.ed_15_24Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imagingHuijuan MiaoLeticia SimoLiying GuoHuimin FanPan GuZhaohui SongXiaokun GengYuchuan DingObjectives: Follow-up observation of changes in intracranial plaques and lenticulostriate arteries (LSAs) under the standard medical treatment can help further observe treatment effects. This study aims to observe the changes in symptomatic intracranial atherosclerosis plaques and LSAs under conventional medical treatment using high-resolution magnetic resonance imaging (HR-MRI). Subjects and Methods: Thirty-eight symptomatic middle cerebral artery stenotic patients were consecutively enrolled from October 2016 to July 2018 and HR-MRI was performed within the two weeks of the onset of acute ischemic stroke. All patients received standard medical treatment, and HR-MRI was performed at 6 months and 12 months, respectively. The characteristics of plaques and LSAs quantitative analyzed were compared before and after medical treatment. Further analysis was conducted between the subgroups of low-density lipoprotein cholesterol (LDL-C) <1.8 mmol/L and LDL-C ≥1.8 mmol/L to explore whether a lower LDL-C level is more closely associated with improvement. Results: Ultimately, 23 patients completed the first examination, and among them, 8 patients completed the second examination. After an average of 8.3 months of treatment in 23 patients, the remodeling index (1.26 ± 0.22 vs. 1.14 ± 0.16, P = 0.008), plaque volume (58.92 ± 26.61 mm3 vs. 42.26 ± 19.60 mm3, P = 0.001), plaque burden (88.29 ± 5.88% vs. 83.42 ± 11.04%, P = 0.033, enhancement volume (20.29 [16.44, 28.59] mm3 vs. 12.00 [0.00, 18.13] mm3, P = 0.000), and enhancement index (EI,0.98 ± 0.44 vs. 0.61 ± 0.48, P = 0.000) were significantly decreased compared to baseline. Repeated-measures analysis of variance showed that only the EI (P = 0.019) and the contrast of signal intensity-based on the pituitary funnel (P = 0.035) exhibited statistically significant differences among these groups. A significant difference in PB (P = 0.01) was observed between the two LDL-C subgroups. Conclusions: HR-MRI can help evaluate the medical effects, different kinds of changes on culprit plaques indicate the effectiveness of standard medical treatment. While standard medical treatment can promote the stability of plaques, the relationship between treatment and changes in LSAs remains unclear. Trial Registration: http://www.clinicaltrials.gov (identifier: NCT02719652).https://journals.lww.com/10.4103/ed.ed_15_24atherosclerotic plaquehigh-resolution magnetic resonance imaginglenticulostriate arteriesstandard medical treatmentsymptomatic intracranial atherosclerosis
spellingShingle Huijuan Miao
Leticia Simo
Liying Guo
Huimin Fan
Pan Gu
Zhaohui Song
Xiaokun Geng
Yuchuan Ding
Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
Environmental Disease
atherosclerotic plaque
high-resolution magnetic resonance imaging
lenticulostriate arteries
standard medical treatment
symptomatic intracranial atherosclerosis
title Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
title_full Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
title_fullStr Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
title_full_unstemmed Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
title_short Changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high-resolution magnetic resonance imaging
title_sort changes in symptomatic intracranial atherosclerotic plaques and perforating arteries under medical treatment using high resolution magnetic resonance imaging
topic atherosclerotic plaque
high-resolution magnetic resonance imaging
lenticulostriate arteries
standard medical treatment
symptomatic intracranial atherosclerosis
url https://journals.lww.com/10.4103/ed.ed_15_24
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