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  • Huang, Yining  (4)
  • 1
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Background: The presence of luminal thrombus is associated with a high risk of stroke recurrence. Using high-resolution magnetic resonance imaging(HRMRI) and susceptibility-weighted imaging(SWI), luminal thrombus can be identified in vivo. We aimed to investigate the occurrence of luminal thrombus in patients with acute ischemic stroke. Methods: Patients with first ever stroke within 72 hours from onset, confirmed by diffusion weighted imaging, were recruited from 16 medical centers. Conventional MRI, magnetic resonance angiography, HRMRI (including 3-dimentional T1 images and 2-dimentional T2 images), and SWI were performed. Luminal thrombus was identified if isointense/hyperintense signals on 3-dimentional T1 images of HRMRI or susceptibility vessel sign on SWI were observed within the course of intracranial arteries. Results: Six hundred and one patients (70% male, mean age 61±16 years old, mean NIHSS 6± 5) were enrolled. Among them, 112 patients underwent recanalization therapies. Median time from symptom onset to MRI was 44 ± 20 hours. Luminal thrombus was identified in 138 (23%)patients. The occurrence rate of luminal thrombus was non-significantly different between the patients treated with and without recanalization therapies(16% vs.25%, p=0.054). Symptomatic luminal thrombus was more likely observed in large artery atherosclerosis stroke(121/240,50%) and cardicac stroke(11/36,31%) than other stroke subtypes (0/288 in lacunar stroke, 0/6 in stroke of undetermined etiology and 1/31 in cryptogenic stroke, P 〈 0.001). There were five patients with asymptomatic luminal thrombus irrelevant to ischemic lesions. Conclusions: Luminal thrombus is common in patients with acute ischemic stroke within 72 hours from onset. Further studies are required to clarify whether in vivo thrombus imaging can predict early stroke recurrence.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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  • 2
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Background: Pathology studies suggested obstruction of the origins of penetrating arteries by parent intracranial artery plaque can cause an infarct. Using high-resolution magnetic resonance imaging(HRMRI), intracranial plaque distribution can be identified in vivo. We aimed to investigate the occurrence rate of parent intracranial artery plaque in patients with acute penetrating artery territory infarcts. Methods: Patients with first ever stroke within 72 hours from onset, confirmed by diffusion weighted imaging, were recruited from 16 medical centers. Conventional magnetic resonance imaging (MRI), magnetic resonance angiography, HRMRI (including 3-dimentional T1 images and 2-dimentional T2 images) and susceptibility-weighted imaging were performed. All patients received thorough evaluations to determine the cause of stroke according to TOAST classifications. A plaque was identified if there was eccentric wall thickening, whereas the thinnest part was estimated to be less than 50% of the thickest point by visual inspection. The plaques within middle cerebral artery(MCA) were further classified based on their orientation being centered on the superior, inferior, dorsal, or ventral side of the vessel. Possible culprit plaques were defined if superior and/or dorsal MCA plaques ipsilateral to the infarcts were observed. The plaques within basilar artery were further classified based on their orientation being centered on the ventral, dorsal, or lateral sides of the vessel ( ipsilateral to infarcts, or contralateral to infarcts). Possible culprit plaques were defined if dorsal plaques or the plaques ipsilateral to brain stem infarcts were observed. Results: Six hundred and one patients (70% male, mean age 61±16 years old, mean NIHSS 6± 5) were enrolled. Two hundred and eighty-eight(48%) patients were diagnosed with penetrating artery territory infarcts. Of them, 139 patients(48%, 85 MCAs and 54 BAs) had a plaque within the parent intracranial artery of the infarcts. Most of the parent artery plaques(119,85%) were identified as possible culprit plaques. Conclusions: High occurrence rate of parent intracranial artery plaques was observed in patients with acute penetrating artery territory infarcts.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Purpose: We aimed to investigate the prevalence and clinical relevance of the parent artery plaque in acute lacunar stroke. Methods: This prospective, multi-center, observational study included patients with first-ever ischemic stroke within 72 hours of symptom onset. Patients were evaluated by three-dimensional T1-weighted high-resolution magnetic resonance imaging (HR-MRI) and conventional MRI sequences. We examined the presence of intracranial plaque, infarction patterns, and infarct volumes in all the patients with acute lacunar stroke. The outcome measurement was 90-day poor functional outcome (modified Rankin Scale 〉 2). Results: Of the 756 patients included, 341(45.1%) patients had an acute lacunar stroke. There were 201 (58.9%, 201/341) patients with an infarct in deep basal ganglia area. Among them, 64 (31.8%, 64/201) patients had middle cerebral artery (MCA) plaques identified on HR-MRI. The patients with MCA plaque had a similar infarct volume ( 0.93ml vs. 0.88ml , p =0.9) with those without MCA plaque. However, they more likely had an infarct involving posterior limb of internal capsule (42.2%, 27/64 vs. 25.5%, 35/137, p =0.017 ) and had a higher prevalence of cerebral microbleed (68.8%, 44/64 vs. 40.1%, 55/137, p 〈 0.001 ), and moderate to severe perivascular spaces in basal ganglia (BG-PVS)(57.8%, 37/64vs.35.0%, 48/137, p =0.002) . After adjusting for age and National Institute of Health Stroke Scale (NIHSS) at admission, the presence of MCA plaque was independently associated with 90-day poor functional outcome (OR:3.44, [95% CI,1.26-9.42]). There were 102 (29.9%, 102/341) patients with an infarct in pons. Among them, 66 (64.7%, 66/102) patients had basilar artery (BA) plaques. Patients with BA plaque had a higher prevalence of moderate to severe BG-PVS (42.4%, 28/66 vs. 22.2%, 8/36, p =0.041). There were no differences between the patients with and without BA plaque regarding infarction volume and 90-day functional outcome. Conclusions: Parent artery plaque is common in patients with acute lacunar stroke. We propose the deep basal ganglia area infarct with MCA plaque as a unique lacunar stroke subtype with poor prognosis. Our data did not show the presence of BA plaque have an effect on the lacunar stroke prognosis.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Introdution: Intracranial artery atherosclerosis is an important cause of ischemic stroke, especially in people of Asian origin. Intraplaque hemorrhage is supposed to be a predictor of ischemic event. The goal of this study was to examine the occurrence of intraplaque hemorrhage in a large cohort of Chinese patients with acute ischemic stroke. Methods: Patients with first ever stroke within 72 hours from onset, confirmed by diffusion weighted imaging, were recruited from 16 medical centers. Conventional MRI, magnetic resonance angiography, HRMRI (including 3-dimentional T1 images and 2-dimentional T2 images), and SWI were performed. Intraplaque hemorrhage was identified if hyperintense signals on 3-dimentional T1 images of HRMRI were observed within intracranial plaques. Results: Six hundred and one patients (70% male, mean age 61±16 years old, mean NIHSS 6± 5) were enrolled. Median time from symptom onset to MRI was 44 ± 20 hours. Of them, 240(40%) were diagnosed with large artery atherosclerosis (LAA) stroke. Intracranial intraplaque hemorrhage was identified in 15 intracranial plaques of 13 patients with LAA stroke. Six plaques with intraplaque hemorrhage were asymptomatic and irrelevant to ischemic infarct lesions. In 2 patients, both symptomatic and asymptomatic intraplaque hemorrhage were observed. Conclusions: The prevalence of intracranial intraplaque hemorrhage was low (5.4%)in acute stroke patients. The clinical importance of asymptomatic intraplaque hemorrhage need further investigations.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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