A Preliminary Study On The Predictive Value Of HRMR-VWI Plaque Characteristics Combined With Lifestyle In Ischemic Stroke

Objective:To explore the predictive value of combining high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)intracranial plaque characteristics with lifestyle on ischemic stroke.Methods:From January 2018 to September 2022,177 patients with intracranial atherosclerosis who received HRMR-VWI in the First Hospital of Shanxi Medical University were enrolled.According to the conventional brain MRI and diffusion weighted imaging(DWI),the patients were divided into infarction group(104 cases)and non-infarction group(73 cases),The plaque characteristics including the luminal stenosis,plaque enhancement index,plaque burden,arterial remodeling type and intraplaque hemorrhage(IPH)based on HRMR-VWI were measured.To evaluate the patients’ lifestyle,we used Mediterranean Diet Adherence Screener(MEDAS)to assess their diet adherence and used the ideal cardiovascular health(CVH)metrics to analyze their blood pressure,blood cholesterol,blood glucose,body mass index(BMI),smoking status and physical activity.Univariate analysis was used to investigate whether the above factors were significantly different between the two groups,multivariate analysis was used to find independent predictors of ischemic stroke.Drew the receiver operating characteristic(ROC)curves and calculated the area under the curves(AUCs),then evaluated the predictive value of single factor and combined model on ischemic stroke.Results:Univariate analysis showed that there were significant differences between the two groups in plaque burden,luminal stenosis,enhancement index,IPH,blood pressure,blood cholesterol,smoking,and MEDAS score(P<0.05).Multivariate analysis showed that enhancement index(OR=1.010,95% CI 1.002-1.018,P=0.020)and luminal stenosis(OR=1.031,95% CI 1.006-1.057,P=0.015)were risk factors of ischemic stroke.Ideal blood pressure(OR=0.070,95% CI 0.010-0.480,P=0.007),higher MEDAS score(OR=0.736,95% CI 0.564-0.961,P=0.024),ideal physical activity(OR=0.266,95% CI0.087-0.811,P=0.020),and ideal smoking status(OR=0.393,95 CI 0.175-0.884,P=0.024)were protective factors of ischemic stroke.ROC curves showed that the AUC of the combined model(AUC=0.819)was higher than that of plaque enhancement index(AUC=0.693),luminal stenosis(AUC=0.726),MEDAS score(AUC=0.616),blood pressure(AUC=0.571),smoking(AUC=0.601)and physical activity(AUC=0.618)alone.Conclusion:Plaque enhancement and luminal stenosis were the risk factors of ischemic stroke.Higher Mediterranean Diet adherence,keeping ideal blood pressure,ideal physical activity and not smoking or quitting smoking can reduce the risk of ischemic stroke.The combined model can predict the risk of ischemic stroke better.