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Background <p>The Carotid Plaque Reporting and Data System (Plaque-RADS) is a new quantitative grading system for plaque stability. Herein, high-resolution magnetic resonance imaging (HRMRI)-based Plaque-RADS(HRMRI-Plaque-RADS) classification was performed to characterize the different classifications in patients with cerebral infarction.</p> Methods <p>HRMRI images from patients with acute cerebral infarction (ACI) of the anterior cerebral circulation were collected retrospectively, and carotid plaques were categorized into the Plaque-RADS 1–4 subtypes. Plaque-RADS 1 and 2 were considered low-risk, and Plaque-RADS 3 and 4 as high-risk. After contrast agent injection, high-risk plaques were further classified as enhanced or non-enhanced. A mixed-effects logistic regression model was applied to identify relationships between plaque types and infarction.</p> Results <p>This study included 98 patients (age 65.6 ± 9.6 years; 88.8% male; 196 carotid arteries). The distribution of Plaque-RADS 1–4 plaques on the infarction side was: 7 (7.1%), 13 (13.2%), 49 (50.0%), and 29 (29.6%), respectively. Among the high-risk plaques, 50 (51%) were enhanced high-risk. The distribution of Plaque-RADS 1–4 plaques on the contralateral side was: 26 (26.5%), 21 (21.4%), 43 (43.9%), and 8 (8.2%), respectively, with 28 (28.6%) high-risk plaques classified as enhanced high-risk. The high-risk and enhanced high-risk plaque types were significantly associated with the infarction side (odds ratio [OR] = 3.71, 95% confidence interval [CI], 1.96–7.05; <i>P</i> &lt; 0.001, after adjustment; OR = 3.05, 95%CI, 1.78–5.23; <i>P</i> &lt; 0.001).</p> Conclusion <p>In ACI, HRMRI-Plaque-RADS based high-risk and enhanced high-risk plaques were associated with the infarction side. Plaque enhancement offered a supplement to the Plaque-RADS, and HRMRI based Plaque-RADS classification may effectively identify vulnerable plaques.</p>

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Distribution of high-resolution magnetic resonance imaging -based carotid Plaque-RADS subtypes among patients with acute cerebral infarction

  • 期刊论文

  • 发表日期：

    2025年11月15日

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  • Wanchen Liu,
  • Zhiji Zheng,
  • Wenbin Zhang,
  • Xiaolei Lin,
  • Linjie Hu,
  • Zhimeng Cui,
  • Hui Fang,
  • Xin Cao,
  • Daoying Geng

摘要

Background

The Carotid Plaque Reporting and Data System (Plaque-RADS) is a new quantitative grading system for plaque stability. Herein, high-resolution magnetic resonance imaging (HRMRI)-based Plaque-RADS(HRMRI-Plaque-RADS) classification was performed to characterize the different classifications in patients with cerebral infarction.

Methods

HRMRI images from patients with acute cerebral infarction (ACI) of the anterior cerebral circulation were collected retrospectively, and carotid plaques were categorized into the Plaque-RADS 1–4 subtypes. Plaque-RADS 1 and 2 were considered low-risk, and Plaque-RADS 3 and 4 as high-risk. After contrast agent injection, high-risk plaques were further classified as enhanced or non-enhanced. A mixed-effects logistic regression model was applied to identify relationships between plaque types and infarction.

Results

This study included 98 patients (age 65.6 ± 9.6 years; 88.8% male; 196 carotid arteries). The distribution of Plaque-RADS 1–4 plaques on the infarction side was: 7 (7.1%), 13 (13.2%), 49 (50.0%), and 29 (29.6%), respectively. Among the high-risk plaques, 50 (51%) were enhanced high-risk. The distribution of Plaque-RADS 1–4 plaques on the contralateral side was: 26 (26.5%), 21 (21.4%), 43 (43.9%), and 8 (8.2%), respectively, with 28 (28.6%) high-risk plaques classified as enhanced high-risk. The high-risk and enhanced high-risk plaque types were significantly associated with the infarction side (odds ratio [OR] = 3.71, 95% confidence interval [CI], 1.96–7.05; P < 0.001, after adjustment; OR = 3.05, 95%CI, 1.78–5.23; P < 0.001).

Conclusion

In ACI, HRMRI-Plaque-RADS based high-risk and enhanced high-risk plaques were associated with the infarction side. Plaque enhancement offered a supplement to the Plaque-RADS, and HRMRI based Plaque-RADS classification may effectively identify vulnerable plaques.