Abstract：
BACKGROUND: Relatively little is known about the plaque characteristics of border-zone infarcts and how they differ between cortical border-zone (CBZ) and internal border-zone (IBZ) infarcts.
METHODS: We conducted a retrospective observational cohort study of patients with intracranial atherosclerotic disease who underwent high-resolution magnetic resonance imaging (HR-MRI) examination. Individuals with border-zone infarcts in the middle cerebral artery (MCA) territory, detected by diffusion-weighted imaging, were enrolled. Plaque morphological and compositional parameters of both IBZ and CBZ groups were compared. Independent predictors were identified using a binary logistic regression model, and the sensitivity and specificity of the model were assessed using a receiver operating characteristic curve. Kaplan-Meier survival analysis further explored differences in stroke recurrence between BZ patients with mono or dual antiplatelet therapy.
RESULTS: We reviewed 101 symptomatic patients with border-zone infarcts (BZ) within the MCA territory in the study. Out of the patients meeting the imaging eligibility criteria, we detected 34 cases with isolated IBZ, 23 cases with isolated CBZ, and six cases with both IBZ and CBZ infarcts. Those with IBZ infarcts had a higher plaque burden than those without (p < 0.001), and those with CBZ infarcts exhibited a complicated plaque less frequently than those without (37.9% vs 67.6%, p = 0.018). In those with isolated IBZ or CBZ infarcts, plaque burden was independently associated with isolated IBZ infarcts (odd ratio=1.08; 95% CI, 1.02-1.15; p = 0.023). During the median follow-up period of 37 (27, 50) months, 13.8% of patients receiving early dual antiplatelet treatment and 30.4% of those on single antiplatelet therapy experienced stroke recurrence (p = 0.182).
CONCLUSIONS: Intracranial atherosclerotic plaque morphology and composition differ between patients with IBZ and those with CBZ infarcts. Higher plaque burden is more associated with IBZ infarcts.
METHODS: We conducted a retrospective observational cohort study of patients with intracranial atherosclerotic disease who underwent high-resolution magnetic resonance imaging (HR-MRI) examination. Individuals with border-zone infarcts in the middle cerebral artery (MCA) territory, detected by diffusion-weighted imaging, were enrolled. Plaque morphological and compositional parameters of both IBZ and CBZ groups were compared. Independent predictors were identified using a binary logistic regression model, and the sensitivity and specificity of the model were assessed using a receiver operating characteristic curve. Kaplan-Meier survival analysis further explored differences in stroke recurrence between BZ patients with mono or dual antiplatelet therapy.
RESULTS: We reviewed 101 symptomatic patients with border-zone infarcts (BZ) within the MCA territory in the study. Out of the patients meeting the imaging eligibility criteria, we detected 34 cases with isolated IBZ, 23 cases with isolated CBZ, and six cases with both IBZ and CBZ infarcts. Those with IBZ infarcts had a higher plaque burden than those without (p < 0.001), and those with CBZ infarcts exhibited a complicated plaque less frequently than those without (37.9% vs 67.6%, p = 0.018). In those with isolated IBZ or CBZ infarcts, plaque burden was independently associated with isolated IBZ infarcts (odd ratio=1.08; 95% CI, 1.02-1.15; p = 0.023). During the median follow-up period of 37 (27, 50) months, 13.8% of patients receiving early dual antiplatelet treatment and 30.4% of those on single antiplatelet therapy experienced stroke recurrence (p = 0.182).
CONCLUSIONS: Intracranial atherosclerotic plaque morphology and composition differ between patients with IBZ and those with CBZ infarcts. Higher plaque burden is more associated with IBZ infarcts.
摘要：
背景：关于边界区梗死的斑块特征以及它们在皮质边界区（CBZ）和内部边界区（IBZ）梗死之间的差异相对知之甚少。
方法：我们对接受高分辨率磁共振成像（HR-MRI）检查的颅内动脉粥样硬化性疾病患者进行了回顾性观察性队列研究。大脑中动脉（MCA）区域有边界区梗塞的个体，通过扩散加权成像检测，已注册。比较了IBZ和CBZ组的斑块形态和组成参数。使用二元逻辑回归模型确定独立预测因子，使用受试者工作特征曲线评估模型的敏感性和特异性。Kaplan-Meier生存分析进一步探讨了使用单或双联抗血小板治疗的BZ患者之间卒中复发的差异。
结果：我们回顾了101例MCA区域内出现边界区梗死（BZ）的症状患者。符合成像资格标准的患者中，我们发现了34例孤立的IBZ，23例孤立的CBZ，6例同时伴有IBZ和CBZ梗死。那些有IBZ梗死的患者比没有IBZ梗死的患者有更高的斑块负担（p<0.001），与没有CBZ梗塞的人相比，有CBZ梗塞的人表现出复杂的斑块的频率较低（37.9％vs67.6％，p=0.018)。在那些孤立的IBZ或CBZ梗塞的患者中，斑块负荷与孤立的IBZ梗死独立相关(奇数比=1.08;95%CI,1.02-1.15;p=0.023).在37（27，50）个月的中位随访期间，13.8%接受早期双重抗血小板治疗的患者和30.4%接受单一抗血小板治疗的患者出现卒中复发(p=0.182)。
结论：IBZ和CBZ梗死患者的颅内动脉粥样硬化斑块形态和成分不同。较高的斑块负荷与IBZ梗死更相关。
方法：我们对接受高分辨率磁共振成像（HR-MRI）检查的颅内动脉粥样硬化性疾病患者进行了回顾性观察性队列研究。大脑中动脉（MCA）区域有边界区梗塞的个体，通过扩散加权成像检测，已注册。比较了IBZ和CBZ组的斑块形态和组成参数。使用二元逻辑回归模型确定独立预测因子，使用受试者工作特征曲线评估模型的敏感性和特异性。Kaplan-Meier生存分析进一步探讨了使用单或双联抗血小板治疗的BZ患者之间卒中复发的差异。
结果：我们回顾了101例MCA区域内出现边界区梗死（BZ）的症状患者。符合成像资格标准的患者中，我们发现了34例孤立的IBZ，23例孤立的CBZ，6例同时伴有IBZ和CBZ梗死。那些有IBZ梗死的患者比没有IBZ梗死的患者有更高的斑块负担（p<0.001），与没有CBZ梗塞的人相比，有CBZ梗塞的人表现出复杂的斑块的频率较低（37.9％vs67.6％，p=0.018)。在那些孤立的IBZ或CBZ梗塞的患者中，斑块负荷与孤立的IBZ梗死独立相关(奇数比=1.08;95%CI,1.02-1.15;p=0.023).在37（27，50）个月的中位随访期间，13.8%接受早期双重抗血小板治疗的患者和30.4%接受单一抗血小板治疗的患者出现卒中复发(p=0.182)。
结论：IBZ和CBZ梗死患者的颅内动脉粥样硬化斑块形态和成分不同。较高的斑块负荷与IBZ梗死更相关。
