Evaluation value of drug balloon therapy for intracranial atherosclerotic stenosis based on high-resolution vascular wall MRI
10.3760/cma.j.cn112149-20211012-00916
- VernacularTitle:基于高分辨率血管壁MRI评估药物涂层球囊治疗颅内动脉粥样硬化性狭窄的价值
- Author:
Kunjian CHEN
1
;
Xinyi WANG
;
Huimin MAO
;
Yu GUO
;
Xinyu WANG
;
Chao ZHANG
Author Information
1. 山东第一医科大学第一附属医院（山东省千佛山医院）放射科，济南 250014
- Keywords:
Stroke;
Atherosclerosis;
Magnetic resonance imaging
- From:
Chinese Journal of Radiology
2022;56(11):1202-1208
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of high resolution vascular wall MRI (VW-MRI) in drug balloon therapy of intracranial atherosclerotic stenosis.Methods:A total of 21 patients with intracranial atherosclerotic stenosis admitted to the First Affiliated Hospital of Shandong First Medical University from September 2019 to July 2021 were retrospectively analyzed, aged 22-73 (49±15) years, including 15 males and 6 females. All patients were treated with SeQuent Please drug coated balloon recanalization, and performed digital subtraction angiography (DSA), routine MRI and VW-MRI examinations within one week before operation and 2 to 3 months after treatment. The changes of atherosclerotic plaque area, length, enhancement index and stenosis degree before and after recanalization were evaluated. Paired t-test or Wilcoxon test was separately used to compare the difference before and after operation. The value of plaque characteristics in evaluating postoperative efficacy was analyzed by the receiver operating characteristic (ROC) curve. Pearson correlation analysis and Bland-Altman images method were used to test the correlation and consistency of VW-MRI and DSA in measuring the lumen stenosis degree. Results:After endovascular treatment with drug-coated balloon, the plaque area [(1.86±1.28)mm 2], length [3(2, 4)mm],enhancement index [(60±20)%] and lumen stenosis degree [(28±16)%] were significantly lower than those before endovascular treatment [(5.97±1.15)mm 2, t=10.93, P<0.001; 7(6, 9)mm, Z=-3.94, P<0.001; (107±46)%, t=4.26, P<0.001; (89±5)%, t=17.27, P<0.001]. The plaque area, length and enhancement index showed diagnostic value for evaluating the endovascular treatment efficacy (area under the ROC curve=0.89, 0.86, 0.74, respectively). Stenosis degree measured by VW-MRI had a positive correlation ( rpreoperative=0.66, P<0.001; rpostoperative=0.96, P<0.001) and consistency with DSA before and after recanalization. Conclusion:VW-MRI can be used to comprehensively and effectively evaluate treatment effect after endovascular treatment from the changes of plaque basic characteristics and stenosis degree, which is a good imaging follow-up tool.
