Abstract：
OBJECTIVE: Intracranial vessel wall enhancement (VWE) on high-resolution magnetic resonance imaging (HRMRI) is associated with the progression and poor prognosis of moyamoya disease (MMD). This study assessed potential risk factors for VWE in MMD.
METHODS: We evaluated MMD patients using HRMRI and traditional angiography examinations. The participants were divided into VWE and non-VWE groups based on HRMRI. Logistic regression was performed to compare the risk factors for VWE in MMD. The incidence of cerebrovascular events of the different subgroups according to risk factors was compared using Kaplan-Meier survival and Cox regression.
RESULTS: We included 283 MMD patients, 84 of whom had VWE on HRMRI. The VWE group had higher modified Rankin Scale scores at admission (p = 0.014) and a higher incidence of ischaemia and haemorrhage (p = 0.002) than did the non-VWE group. Risk factors for VWE included the ring finger protein 213 (RNF213) p.R4810K variant (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.08-3.76, p = 0.028), hyperhomocysteinaemia (HHcy) (OR 5.08, 95% CI 2.34-11.05, p < 0.001), and smoking history (OR 3.49, 95% CI 1.08-11.31, p = 0.037). During the follow-up of 63.9 ± 13.2 months (median 65 months), 18 recurrent stroke events occurred. Cox regression showed that VWE and the RNF213 p.R4810K variant were risk factors for stroke.
CONCLUSIONS: The RNF213 p.R4810K variant is strongly associated with VWE and poor prognosis in MMD. HHcy and smoking are independent risk factors for VWE.
CONCLUSIONS: Vessel wall enhancement in moyamoya disease is closely associated with poor prognosis, especially related to the ring finger protein 213 p.R4810K variant, hyperhomocysteinaemia, and smoking, providing crucial risk assessment information for the clinic.
CONCLUSIONS: • The baseline presence of vessel wall enhancement is significantly associated with poor prognosis in moyamoya disease. • The ring finger protein 213 p.R4810K variant is strongly associated with vessel wall enhancement and poor prognosis in moyamoya disease. • Hyperhomocysteinaemia and smoking are independent risk factors for vessel wall enhancement in moyamoya disease.
METHODS: We evaluated MMD patients using HRMRI and traditional angiography examinations. The participants were divided into VWE and non-VWE groups based on HRMRI. Logistic regression was performed to compare the risk factors for VWE in MMD. The incidence of cerebrovascular events of the different subgroups according to risk factors was compared using Kaplan-Meier survival and Cox regression.
RESULTS: We included 283 MMD patients, 84 of whom had VWE on HRMRI. The VWE group had higher modified Rankin Scale scores at admission (p = 0.014) and a higher incidence of ischaemia and haemorrhage (p = 0.002) than did the non-VWE group. Risk factors for VWE included the ring finger protein 213 (RNF213) p.R4810K variant (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.08-3.76, p = 0.028), hyperhomocysteinaemia (HHcy) (OR 5.08, 95% CI 2.34-11.05, p < 0.001), and smoking history (OR 3.49, 95% CI 1.08-11.31, p = 0.037). During the follow-up of 63.9 ± 13.2 months (median 65 months), 18 recurrent stroke events occurred. Cox regression showed that VWE and the RNF213 p.R4810K variant were risk factors for stroke.
CONCLUSIONS: The RNF213 p.R4810K variant is strongly associated with VWE and poor prognosis in MMD. HHcy and smoking are independent risk factors for VWE.
CONCLUSIONS: Vessel wall enhancement in moyamoya disease is closely associated with poor prognosis, especially related to the ring finger protein 213 p.R4810K variant, hyperhomocysteinaemia, and smoking, providing crucial risk assessment information for the clinic.
CONCLUSIONS: • The baseline presence of vessel wall enhancement is significantly associated with poor prognosis in moyamoya disease. • The ring finger protein 213 p.R4810K variant is strongly associated with vessel wall enhancement and poor prognosis in moyamoya disease. • Hyperhomocysteinaemia and smoking are independent risk factors for vessel wall enhancement in moyamoya disease.
摘要：
目的：高分辨率磁共振成像（HRMRI）的颅内血管壁强化（VWE）与烟雾病（MMD）的进展和不良预后相关。这项研究评估了MMD中VWE的潜在危险因素。
方法：我们使用HRMRI和传统血管造影检查评估了MMD患者。根据HRMRI将参与者分为VWE和非VWE组。采用Logistic回归分析比较MMD患者发生VWE的危险因素。使用Kaplan-Meier生存和Cox回归比较不同危险因素不同亚组的脑血管事件发生率。
结果：我们纳入了283例MMD患者，其中84人在HRMRI上有VWE。VWE组入院时改良Rankin量表评分较高（p=0.014），缺血和出血发生率较高（p=0.002）。VWE的危险因素包括无名指蛋白213（RNF213）p.R4810K变体（比值比[OR]2.01，95％置信区间[CI]1.08-3.76，p=0.028），高同型半胱氨酸血症（HHcy）（OR5.08，95％CI2.34-11.05，p<0.001），吸烟史（OR3.49，95%CI1.08-11.31，p=0.037）。随访63.9±13.2个月（中位数65个月），发生18例复发性卒中事件。Cox回归显示VWE和RNF213p.R4810K变异体是卒中的危险因素。
结论：RNF213p.R4810K变异与VWE和MMD的不良预后密切相关。HHcy和吸烟是VWE的独立危险因素。
结论：烟雾病血管壁强化与预后不良密切相关，特别是与无名指蛋白213p.R4810K变体有关，高同型半胱氨酸血症,吸烟,为临床提供关键的风险评估信息。
结论：•基线血管壁强化的存在与烟雾病的不良预后显著相关。•无名指蛋白213p.R4810K变体与烟雾病中的血管壁增强和不良预后密切相关。•高同型半胱氨酸血症和吸烟是烟雾病中血管壁增强的独立危险因素。
方法：我们使用HRMRI和传统血管造影检查评估了MMD患者。根据HRMRI将参与者分为VWE和非VWE组。采用Logistic回归分析比较MMD患者发生VWE的危险因素。使用Kaplan-Meier生存和Cox回归比较不同危险因素不同亚组的脑血管事件发生率。
结果：我们纳入了283例MMD患者，其中84人在HRMRI上有VWE。VWE组入院时改良Rankin量表评分较高（p=0.014），缺血和出血发生率较高（p=0.002）。VWE的危险因素包括无名指蛋白213（RNF213）p.R4810K变体（比值比[OR]2.01，95％置信区间[CI]1.08-3.76，p=0.028），高同型半胱氨酸血症（HHcy）（OR5.08，95％CI2.34-11.05，p<0.001），吸烟史（OR3.49，95%CI1.08-11.31，p=0.037）。随访63.9±13.2个月（中位数65个月），发生18例复发性卒中事件。Cox回归显示VWE和RNF213p.R4810K变异体是卒中的危险因素。
结论：RNF213p.R4810K变异与VWE和MMD的不良预后密切相关。HHcy和吸烟是VWE的独立危险因素。
结论：烟雾病血管壁强化与预后不良密切相关，特别是与无名指蛋白213p.R4810K变体有关，高同型半胱氨酸血症,吸烟,为临床提供关键的风险评估信息。
结论：•基线血管壁强化的存在与烟雾病的不良预后显著相关。•无名指蛋白213p.R4810K变体与烟雾病中的血管壁增强和不良预后密切相关。•高同型半胱氨酸血症和吸烟是烟雾病中血管壁增强的独立危险因素。
