Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study
IntroductionThe temporal dynamics of the vessel wall in intracranial arterial disease (ICAD) may differ depending on the etiology. We investigated temporal changes in narrowed intracranial arteries after ischemic stroke using serial high-resolution vessel wall imaging (HR-VWI).MethodsWe retrospectiv...
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Frontiers Media S.A.
2025-06-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1583857/full |
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| author | Dong-Wan Kang Dong-Wan Kang Jonguk Kim Jonguk Kim Do Yeon Kim Do Yeon Kim Do Yeon Kim Sung Hyun Baik Cheolkyu Jung Bijoy K. Menon Jae W. Song Moon-Ku Han Hee-Joon Bae Beom Joon Kim |
| author_facet | Dong-Wan Kang Dong-Wan Kang Jonguk Kim Jonguk Kim Do Yeon Kim Do Yeon Kim Do Yeon Kim Sung Hyun Baik Cheolkyu Jung Bijoy K. Menon Jae W. Song Moon-Ku Han Hee-Joon Bae Beom Joon Kim |
| author_sort | Dong-Wan Kang |
| collection | DOAJ |
| description | IntroductionThe temporal dynamics of the vessel wall in intracranial arterial disease (ICAD) may differ depending on the etiology. We investigated temporal changes in narrowed intracranial arteries after ischemic stroke using serial high-resolution vessel wall imaging (HR-VWI).MethodsWe retrospectively recruited patients with ICAD-related ischemic stroke who underwent two or more HR-VWI scans. The lumen area (LA), total vessel area (TVA), and enhancing area (EA) of the narrowest part of the culprit lesion were manually segmented. Degree of stenosis was estimated as [1-LA/TVA] × 100(%), the enhancing proportion as EA/TVA × 100(%), and enhancement ratio as (T1GDlesion/T1GDref)/(T1lesion/T1ref). Linear mixed models were used to investigate temporal changes in these parameters and whether such changes differed by etiologies.ResultsOf a total of 208 patients, ICAD-related stroke was caused by atherosclerosis (69%), arterial dissection (24%), vasculitis (3%), moyamoya disease (1%), and other (2%). The median follow-up was 319 [IQR, 125–409] days. HR-VWI imaging parameters, namely, degree of stenosis, enhancing proportion, and enhancement ratio showed a trend to decrease over time. Patients with intracranial dissection as a cause of intracranial narrowing showed a faster reduction in degree of stenosis and enhancing proportion vs. when such narrowing was identified as due to atherosclerosis (β [95% CI], −0.59%[−0.80% ~ −0.38%] and −0.81%[−1.23% ~ −0.39%], respectively, both p < 0.01). The enhancement ratio did not change over time in dissection, while it decreased in atherosclerosis (−0.01 [−0.02 ~ 0], p = 0.04).ConclusionIntracranial vessel narrowing in patients with ischemic stroke changes over time with different stroke etiologies having their own unique temporal patterns. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-4159ccfa00064ed79e2ddd3617f0134c2025-08-20T02:07:41ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15838571583857Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging studyDong-Wan Kang0Dong-Wan Kang1Jonguk Kim2Jonguk Kim3Do Yeon Kim4Do Yeon Kim5Do Yeon Kim6Sung Hyun Baik7Cheolkyu Jung8Bijoy K. Menon9Jae W. Song10Moon-Ku Han11Hee-Joon Bae12Beom Joon Kim13Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurology, Inha University Hospital, Incheon, Republic of KoreaDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Public Health, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurology, Gyeonggi Provincial Medical Center, Icheon Hospital, Icheon, Republic of KoreaDepartment of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, CanadaDepartment of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of KoreaIntroductionThe temporal dynamics of the vessel wall in intracranial arterial disease (ICAD) may differ depending on the etiology. We investigated temporal changes in narrowed intracranial arteries after ischemic stroke using serial high-resolution vessel wall imaging (HR-VWI).MethodsWe retrospectively recruited patients with ICAD-related ischemic stroke who underwent two or more HR-VWI scans. The lumen area (LA), total vessel area (TVA), and enhancing area (EA) of the narrowest part of the culprit lesion were manually segmented. Degree of stenosis was estimated as [1-LA/TVA] × 100(%), the enhancing proportion as EA/TVA × 100(%), and enhancement ratio as (T1GDlesion/T1GDref)/(T1lesion/T1ref). Linear mixed models were used to investigate temporal changes in these parameters and whether such changes differed by etiologies.ResultsOf a total of 208 patients, ICAD-related stroke was caused by atherosclerosis (69%), arterial dissection (24%), vasculitis (3%), moyamoya disease (1%), and other (2%). The median follow-up was 319 [IQR, 125–409] days. HR-VWI imaging parameters, namely, degree of stenosis, enhancing proportion, and enhancement ratio showed a trend to decrease over time. Patients with intracranial dissection as a cause of intracranial narrowing showed a faster reduction in degree of stenosis and enhancing proportion vs. when such narrowing was identified as due to atherosclerosis (β [95% CI], −0.59%[−0.80% ~ −0.38%] and −0.81%[−1.23% ~ −0.39%], respectively, both p < 0.01). The enhancement ratio did not change over time in dissection, while it decreased in atherosclerosis (−0.01 [−0.02 ~ 0], p = 0.04).ConclusionIntracranial vessel narrowing in patients with ischemic stroke changes over time with different stroke etiologies having their own unique temporal patterns.https://www.frontiersin.org/articles/10.3389/fneur.2025.1583857/fullintracranial arterial diseaseischemic strokemagnetic resonance imaginghigh-resolution vessel wall imagingfollow-up MRI |
| spellingShingle | Dong-Wan Kang Dong-Wan Kang Jonguk Kim Jonguk Kim Do Yeon Kim Do Yeon Kim Do Yeon Kim Sung Hyun Baik Cheolkyu Jung Bijoy K. Menon Jae W. Song Moon-Ku Han Hee-Joon Bae Beom Joon Kim Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study Frontiers in Neurology intracranial arterial disease ischemic stroke magnetic resonance imaging high-resolution vessel wall imaging follow-up MRI |
| title | Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study |
| title_full | Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study |
| title_fullStr | Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study |
| title_full_unstemmed | Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study |
| title_short | Temporal changes in symptomatic intracranial arterial disease: a longitudinal high-resolution vessel wall imaging study |
| title_sort | temporal changes in symptomatic intracranial arterial disease a longitudinal high resolution vessel wall imaging study |
| topic | intracranial arterial disease ischemic stroke magnetic resonance imaging high-resolution vessel wall imaging follow-up MRI |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1583857/full |
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