Abstract：
BACKGROUND: The association between the degree of plaque enhancement and ischemic brain stroke recurrence remains unclear. We aimed to establish models to predict plaque enhancement and stroke recurrence.
METHODS: Seventy-eight participants with acute ischemic brain stroke due to intracranial arterial stenosis were recruited and divided into high enhancement (HE) and non-HE groups. The relationship between imaging characteristics (degree of stenosis, minimal lumen area, intraplaque hemorrhage, and plaque burden) and the degree of plaque contrast enhancement was analyzed. Inflammatory cytokine expression was examined by flow cytometry. Independent predictors of stroke recurrence were investigated via multivariate Cox proportional hazards regression analysis. Nomogram was used to construct a prediction model. Harrell\'s concordance indices (c-indices) and calibration curves were used to assess the discrimination of the nomogram. A risk prediction nomogram for prognosis was constructed.
RESULTS: Thirty-three participants were assigned to the HE group and 45 to the non-HE group. The degree of stenosis and plaque burden in the HE group was higher than that in the non-HE group (P<0.05). Multiple linear regression analysis showed the degree of stenosis was associated with HE (β=0.513; P=0.000). After adjusting for confounding factors, age (HR=1.115; 95%CI=1.034-1.203, P=0.005) and HE plaques (HR=10.457; 95%CI=1.176-93.018; P=0.035) were independent risk factors of stroke recurrence, whereas cytokine levels were not statistically significant between two group.
CONCLUSIONS: HE of intracranial atherosclerosis plaques is an independent factor for ischemic brain stroke recurrence.
METHODS: Seventy-eight participants with acute ischemic brain stroke due to intracranial arterial stenosis were recruited and divided into high enhancement (HE) and non-HE groups. The relationship between imaging characteristics (degree of stenosis, minimal lumen area, intraplaque hemorrhage, and plaque burden) and the degree of plaque contrast enhancement was analyzed. Inflammatory cytokine expression was examined by flow cytometry. Independent predictors of stroke recurrence were investigated via multivariate Cox proportional hazards regression analysis. Nomogram was used to construct a prediction model. Harrell\'s concordance indices (c-indices) and calibration curves were used to assess the discrimination of the nomogram. A risk prediction nomogram for prognosis was constructed.
RESULTS: Thirty-three participants were assigned to the HE group and 45 to the non-HE group. The degree of stenosis and plaque burden in the HE group was higher than that in the non-HE group (P<0.05). Multiple linear regression analysis showed the degree of stenosis was associated with HE (β=0.513; P=0.000). After adjusting for confounding factors, age (HR=1.115; 95%CI=1.034-1.203, P=0.005) and HE plaques (HR=10.457; 95%CI=1.176-93.018; P=0.035) were independent risk factors of stroke recurrence, whereas cytokine levels were not statistically significant between two group.
CONCLUSIONS: HE of intracranial atherosclerosis plaques is an independent factor for ischemic brain stroke recurrence.
摘要：
背景：斑块增强程度与缺血性脑卒中复发之间的关系尚不清楚。我们旨在建立预测斑块增强和卒中复发的模型。
方法：招募了78名因颅内动脉狭窄导致急性缺血性脑卒中的参与者，并将其分为高增强（HE）和非HE组。影像学特征(狭窄程度、最小管腔面积,斑块内出血,和斑块负荷）并分析斑块对比增强的程度。通过流式细胞术检查炎性细胞因子的表达。通过多变量Cox比例风险回归分析研究卒中复发的独立预测因素。使用列线图构建预测模型。使用Harrell的一致性指数（c指数）和校准曲线来评估列线图的区别。构建了用于预后的风险预测列线图。
结果：将33名参与者分配到HE组，将45名参与者分配到非HE组。HE组狭窄程度及斑块负荷高于非HE组(P<0.05)。多元线性回归分析显示狭窄程度与HE相关(β=0.513;P=0.000)。在调整混杂因素后，年龄(HR=1.115;95CI=1.034-1.203,P=0.005)和HE斑块(HR=10.457;95CI=1.176-93.018;P=0.035)是脑卒中复发的独立危险因素,而细胞因子水平在两组间无统计学意义。
结论：颅内动脉粥样硬化斑块的HE是缺血性脑卒中复发的独立因素。
方法：招募了78名因颅内动脉狭窄导致急性缺血性脑卒中的参与者，并将其分为高增强（HE）和非HE组。影像学特征(狭窄程度、最小管腔面积,斑块内出血,和斑块负荷）并分析斑块对比增强的程度。通过流式细胞术检查炎性细胞因子的表达。通过多变量Cox比例风险回归分析研究卒中复发的独立预测因素。使用列线图构建预测模型。使用Harrell的一致性指数（c指数）和校准曲线来评估列线图的区别。构建了用于预后的风险预测列线图。
结果：将33名参与者分配到HE组，将45名参与者分配到非HE组。HE组狭窄程度及斑块负荷高于非HE组(P<0.05)。多元线性回归分析显示狭窄程度与HE相关(β=0.513;P=0.000)。在调整混杂因素后，年龄(HR=1.115;95CI=1.034-1.203,P=0.005)和HE斑块(HR=10.457;95CI=1.176-93.018;P=0.035)是脑卒中复发的独立危险因素,而细胞因子水平在两组间无统计学意义。
结论：颅内动脉粥样硬化斑块的HE是缺血性脑卒中复发的独立因素。
