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KMID : 1103720180780040249
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Journal of the Korean Society of Radiology
2018 Volume.78 No. 4 p.249 ~ p.258
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The Added Prognostic Value of Intracranial Artery Morphology to Predict Non-Cardioembolic Ischemic Stroke
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Han Na-Hye
Jang Jin-Hee
Byun Ho-Kyun
Lee Ki-Jeong
Koo Ja-Seong
Choi Hyun-Seok
Jung So-Lyung
Ahn Kook-Jin
Kim Bum-Soo
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Abstract
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Purpose: To assess the added prognostic value of the morphologic characteristics of intracranial arteries in the risk modeling of a future non-cardioembolic stroke.
Materials and Methods: This retrospective study included 86 patients without acute ischemic stroke who first underwent magnetic resonance imaging (MRI) including the time-of-flight magnetic resonance angiography (TOF-MRA) at 3T. Diffusion-weighted imaging (DWI) was performed for the follow-up imaging of these patients > 120 days after the initial MRI. The TOF-MRA result was used to analyze three morphological characteristics: dilatation, stenosis, and tortuosity. The presence of acute ischemic stroke was assessed using the follow-up DWI data. We built two prognostic models: model 1 includes the conventional stroke-risk factors, while model 2 includes the conventional risk factors and the morphologic characteristics of the intracranial arteries. We used the likelihood-ratio test to compare these two models. The models' performances were evaluated using Harrell's concordance index.
Results: Fourteen patients suffered non-cardioembolic strokes. The performances of the two models differed significantly regarding the future-risk modeling of the non-cardioembolic stroke (p = 0.031). The Harrell's concordance index of model 2 (0.78 ± 0.05) exceeded that of model 1 (0.72 ± 0.07).
Conclusion: In addition to the conventional stroke-risk factors, the morphologic characteristics of the intracranial arteries were useful in the modeling of the future risk of the non-cardioembolic ischemic stroke.
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KEYWORD
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Cerebral Arteries, Morphology, MRI Angiography, Brain Infarction, Intracranial Arteriosclerosis
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