The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence
Abstract Purpose To assess the associations between cerebral vessels morphological features, white matter hyperintensities (WMHs), and the one-year risk of ischemic stroke recurrence. Methods A total of 677 patients diagnosed with acute ischemic stroke from January 2018 to April 2021 were consecutiv...
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BMC
2025-05-01
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| Series: | BMC Medical Imaging |
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| Online Access: | https://doi.org/10.1186/s12880-025-01687-0 |
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| author | Hao Wang Guoqing Wu Bei Wang Ying Liu Lan Zheng He Wang Jing Ding |
| author_facet | Hao Wang Guoqing Wu Bei Wang Ying Liu Lan Zheng He Wang Jing Ding |
| author_sort | Hao Wang |
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| description | Abstract Purpose To assess the associations between cerebral vessels morphological features, white matter hyperintensities (WMHs), and the one-year risk of ischemic stroke recurrence. Methods A total of 677 patients diagnosed with acute ischemic stroke from January 2018 to April 2021 were consecutively enrolled. Head computed tomography angiography (CTA) and magnetic resonance imaging including fluid-attenuated inversion recovery (FLAIR), were obtained on admission. Cerebral vessels morphological features such as volume, length, radius, density, tortuosity, branch complexity, and degree of stenosis were extracted and calculated using CTA data. Additionally, automated segmentation was employed for delineating WMHs lesions based on FLAIR images. By incorporating clinical characteristics, six predictive models were developed using Cox proportional hazards analysis to estimate the one-year risk of stroke recurrence. The performance of these models was evaluated by comparing the concordance index (C-index). Results The study found significant associations between the lack of antiplatelet therapy at discharge, reduced length and branching of cerebral vessels, and increased burden of WMHs, with a higher one-year risk of recurrent ischemic stroke (all P < 0.05). The integrated model demonstrated superior prognostic capability (C-index: 0.750; 95% CI: 0.684–0.817), outperforming models based solely on clinical characteristics (C-index: 0.636; 95% CI: 0.555–0.717), cerebral vessels morphology (C-index: 0.601; 95% CI: 0.526–0.676), and WMHs burden (C-index: 0.680; 95% CI: 0.603–0.757). Conclusion The quantitative assessment of cerebral vessels morphological features and WMHs provides a promising neuroimaging tool for estimating the one-year risk of ischemic stroke recurrence. The incorporation of cerebral vessels morphological features enhances the predictive accuracy. |
| format | Article |
| id | doaj-art-6fbb5188afc242afaa80cf8a408e41bb |
| institution | Kabale University |
| issn | 1471-2342 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj-art-6fbb5188afc242afaa80cf8a408e41bb2025-08-20T03:53:16ZengBMCBMC Medical Imaging1471-23422025-05-0125111310.1186/s12880-025-01687-0The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrenceHao Wang0Guoqing Wu1Bei Wang2Ying Liu3Lan Zheng4He Wang5Jing Ding6Department of Neurology, Zhongshan Hospital, Fudan UniversityDepartment of Electronic Engineering, Fudan UniversityInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan UniversityDepartment of Neurology, Zhongshan Hospital, Fudan UniversityDepartment of Neurology, Minhang Hospital, Fudan UniversityInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan UniversityDepartment of Neurology, Zhongshan Hospital, Fudan UniversityAbstract Purpose To assess the associations between cerebral vessels morphological features, white matter hyperintensities (WMHs), and the one-year risk of ischemic stroke recurrence. Methods A total of 677 patients diagnosed with acute ischemic stroke from January 2018 to April 2021 were consecutively enrolled. Head computed tomography angiography (CTA) and magnetic resonance imaging including fluid-attenuated inversion recovery (FLAIR), were obtained on admission. Cerebral vessels morphological features such as volume, length, radius, density, tortuosity, branch complexity, and degree of stenosis were extracted and calculated using CTA data. Additionally, automated segmentation was employed for delineating WMHs lesions based on FLAIR images. By incorporating clinical characteristics, six predictive models were developed using Cox proportional hazards analysis to estimate the one-year risk of stroke recurrence. The performance of these models was evaluated by comparing the concordance index (C-index). Results The study found significant associations between the lack of antiplatelet therapy at discharge, reduced length and branching of cerebral vessels, and increased burden of WMHs, with a higher one-year risk of recurrent ischemic stroke (all P < 0.05). The integrated model demonstrated superior prognostic capability (C-index: 0.750; 95% CI: 0.684–0.817), outperforming models based solely on clinical characteristics (C-index: 0.636; 95% CI: 0.555–0.717), cerebral vessels morphology (C-index: 0.601; 95% CI: 0.526–0.676), and WMHs burden (C-index: 0.680; 95% CI: 0.603–0.757). Conclusion The quantitative assessment of cerebral vessels morphological features and WMHs provides a promising neuroimaging tool for estimating the one-year risk of ischemic stroke recurrence. The incorporation of cerebral vessels morphological features enhances the predictive accuracy.https://doi.org/10.1186/s12880-025-01687-0Ischemic strokeStroke recurrenceVessels morphological alterationWhite matter hyperintensitiesSecondary prevention |
| spellingShingle | Hao Wang Guoqing Wu Bei Wang Ying Liu Lan Zheng He Wang Jing Ding The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence BMC Medical Imaging Ischemic stroke Stroke recurrence Vessels morphological alteration White matter hyperintensities Secondary prevention |
| title | The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence |
| title_full | The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence |
| title_fullStr | The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence |
| title_full_unstemmed | The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence |
| title_short | The impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one-year risk of ischemic stroke recurrence |
| title_sort | impact of cerebral vessels morphological alteration and white matter hyperintensities burden on the one year risk of ischemic stroke recurrence |
| topic | Ischemic stroke Stroke recurrence Vessels morphological alteration White matter hyperintensities Secondary prevention |
| url | https://doi.org/10.1186/s12880-025-01687-0 |
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