Open AccessAssociation of severity between carotid and intracranial artery atherosclerosis
Author(s) -
Xu Yilan,
Li Dongye,
Yuan Chun,
Zhou Zechen,
He Le,
Li Rui,
Cui Yuanyuan,
Li Qing,
Zheng Zhuozhao,
Zhao Xihai
Publication year - 2018
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.590
Subject(s) - medicine , stenosis , confounding , odds ratio , carotid arteries , confidence interval , cardiology , radiology , magnetic resonance imaging , receiver operating characteristic , internal carotid artery
Objective This study sought to investigate the relationship of atherosclerosis between intracranial and extracranial carotid arteries using three‐dimensional multicontrast magnetic resonance ( MR ) vessel wall imaging. Methods Patients with recent cerebrovascular symptoms in anterior circulation were recruited and underwent MR vessel wall imaging for intracranial and extracranial carotid arteries. The plaque burden, including maximum wall thickness (Max WT ) and stenosis, and presence of intraplaque hemorrhage ( IPH ) were assessed. The correlation of the plaque characteristics between intracranial and extracranial carotid arteries was determined. Results In total, 107 patients (mean age: 57.0 ± 11.1 years, 69 males) were recruited. In discriminating intracranial severe stenosis (≥50% stenosis), the odds ratio ( OR ) of Max WT of extracranial carotid arteries was 1.41 (95% confidence interval [ CI ], 0.94–2.11, P = 0.095) and 1.72 (95% CI , 1.04–2.83, P = 0.034) before and after adjusting for confounding factors, respectively. The OR of stenosis of extracranial carotid arteries with increment of 10% was 1.26 (95% CI , 0.99–1.60, P = 0.054) and 1.37 (95% CI , 1.03–1.82, P = 0.033) before and after adjusting for confounding factors, in discriminating intracranial severe stenosis respectively. Receiver operating characteristic analysis revealed that the area under the curve ( AUC ) of Max WT , stenosis, and IPH of extracranial carotid artery plaques was 0.641, 0.605, and 0.603 in discriminating intracranial severe stenosis, respectively. After adjusting for confounding factors, the AUC of Max WT , stenosis, and presence of IPH in extracranial carotid artery plaques increased to 0.812, 0.817 and 0.781, respectively. Interpretation Carotid artery plaque burden is significantly associated with severe intracranial artery stenosis, suggesting that extracranial carotid plaque burden might be an independent indicator for severity of intracranial artery atherosclerosis.