Objective: To investigate the prevalence and predictors of intraplaque hemorrhage (IPH) in ischemic stroke patients with intracranial atherosclerosis. Methods: Ischemic stroke patients with intracranial atherosclerosis who were consecutively admitted to Beijing Tsinghua Changgung Hospital from January 2017 to April 2018 were retrospectively analyzed. High-resolution magnetic resonance vessel wall imaging was used to assess atherosclerotic plaque characteristics of intracranial artery. Possible variables correlated with IPH were compared between IPH and no-IPH groups, as well as in symptomatic IPH and no symptomatic IPH groups. Logistic regression analysis was used to determine the predictors of all IPH and symptomatic IPH in intracranial artery. Results: A total of 276 ischemic stroke patients with intracranial atherosclerosis were included, of which, 41.3% (114/276) were IPH-postive, and 28.1%(32/114) of them were symptomatic. In multivariate regression analysis, maximum wall thickness was independently associated with the presence of all IPH and symptomatic IPH (OR=2.15, 95%CI: (1.42-3.24) and OR=3.46, 95%CI: (1.94-6.17), respectively). Conclusion: The prevalence of IPH in ischemic stroke patients with intracranial atherosclerosis is much higher than expected. Moreover, atherosclerosis plaque burden is independently associated with IPH, but it is non-specific in identifying symptomatic IPH.
目的： 调查高分辨磁共振血管壁成像上所见的斑块内出血在颅内动脉粥样硬化卒中人群的出现率及其相关因素。 方法： 回顾性分析北京清华长庚医院2017年1月至2018年4月连续收治的颅内动脉粥样硬化卒中患者。高分辨磁共振血管壁成像用于评估颅内动脉粥样硬化斑块特征。分别比较所有斑块内出血组及症状性斑块内出血组与无斑块内出血组人口学特征和动脉粥样硬化危险因素，采用logistic回归分析筛选可能的与所有斑块内出血及症状性斑块内出血相关的因素。 结果： 共纳入符合条件的颅内动脉粥样硬化卒中患者276例，年龄（66±11）岁。其中41.3%（114/276）出现至少一个斑块内出血，28.1%（32/114）是症状相关的；多变量回归分析显示，斑块负荷（最大管壁厚度）是所有斑块内出血及症状性斑块内出血的独立预测因素，OR值分别为2.15（95%CI：1.42~3.24）和3.46（95%CI：1.94~6.17）。 结论： 斑块内出血在颅内动脉粥样硬化卒中人群的出现率并不低，动脉粥样硬化斑块负荷是斑块内出血的独立预测因素，但其在识别症状性斑块内出血时不具有特异性。.
Keywords: Atherosclerosis; Cerebral infarction; Magnetic resonance imaging; Vulnerable plaque.