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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Investigating the relationship between intracranial atherosclerotic plaque remodelling and diabetes using high-resolution vessel wall imaging
Yong-Qian Mo, Hai-Yu Luo, Han-Wen Zhang, Yu-Feng Liu, Kan Deng, Xiao-Lei Liu, Biao Huang, Fan Lin
Yong-Qian Mo, Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Hai-Yu Luo, Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Han-Wen Zhang, Yu-Feng Liu, Biao Huang, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, Guangdong Province, China
Han-Wen Zhang, Xiao-Lei Liu, Fan Lin, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518036, Guangdong Province, China
Kan Deng, Research Department, Philips Healthcare, Guangzhou 518000, Guangdong Province, China
Biao Huang, Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, Guangdong Province, China
Co-corresponding authors: Fan Lin and Biao Huang.
Author contributions: Mo YQ, Luo HY, and Zhang HW performed equally in conducting the data analyses and played pivotal roles in drafting and refining the manuscript; Deng K, Zhang HW, and Liu YF also made substantial contributions to the data analysis and manuscript preparation, enriching the intellectual content of the work; Liu XL helped perform the analysis with constructive discussions. Lin F and Huang B have been designated as co-corresponding authors due to their instrumental roles in conceiving, developing, and supporting the study. Beyond offering critical insights and design perspectives, both authors provided substantial project support, underscoring their commitment to the research's success. Their collaborative leadership ensured the study's robust conceptualization, and their shared responsibilities reflect a deep involvement in securing resources and facilitating the project's progression. Recognized for their equal and significant contributions, Lin F and Huang B's roles as co-corresponding authors highlight not only their intellectual input but also their tangible support, reinforcing the importance of their involvement in every aspect of the study. Luo HY contributed equally to this article as Mo YQ, for which our team expresses gratitude.
Supported by National Natural Science Foundation of China, No. 82071871; Guangdong Basic and Applied Basic Research Foundation, No. 2021A1515220131; Guangdong Medical Science and Technology Research Fund Project, No. 2022111520491834; and Clinical Research Project of Shenzhen Second People's Hospital, No. 20223357022.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Peking University Shenzhen Hospital.
Informed consent statement: This study was retrospective, and the patient information was anonymized. The patients were therefore exempted from signing informed consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) licence, which permits others to distribute, remix, adapt, build upon this work noncommercially, and licence their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See:
https://creativecommons.org/Licences/bync/4.0/ Corresponding author: Fan Lin, MD, Doctor, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, No. 3002 Sungangxi Road, Shenzhen 518036, Guangdong Province, China. foxetfoxet@gmail.com
Received: October 11, 2023
Peer-review started: October 11, 2023
First decision: November 2, 2023
Revised: November 14, 2023
Accepted: December 13, 2023
Article in press: December 13, 2023
Published online: January 15, 2024
BACKGROUND
Intracranial atherosclerosis, a leading cause of stroke, involves arterial plaque formation. This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging (HR-VWI).
AIM
To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.
METHODS
Ninety-four patients diagnosed with middle cerebral artery or basilar artery atherosclerosis were enrolled. Their basic clinical data were collected, and HR-VWI was performed. The vascular area at the plaque (VAMLN) and normal reference vessel (VAreference) were delineated and measured using image postprocessing software, and the Remodelling index (RI) was calculated. According to the value of the RI, the patients were divided into a positive remodelling (PR) group, intermediate remodelling (IR) group, negative remodelling (NR) group, PR group and non-PR (N-PR) group.
RESULTS
The PR group exhibited a higher prevalence of diabetes and serum cholesterol levels than the IR and NR groups [45.2%, 4.54 (4.16, 5.93) vs 25%, 4.80 ± 1.22 and 16.4%, 4.14 (3.53, 4.75), respectively, P < 0.05]. The diabetes incidence was also significantly greater in the PR group than in the N-PR group (45.2% vs 17.5%, P < 0.05). Furthermore, the PR group displayed elevated serum triglyceride and cholesterol levels compared to the N-PR group [1.64 (1.23, 2.33) and 4.54 (4.16, 5.93) vs 4.54 (4.16, 5.93) and 4.24 (3.53, 4.89), P < 0.05]. Logistic regression analysis revealed diabetes mellitus as an independent influencing factor in plaque-PR [odds ratio (95% confidence interval): 3.718 (1.207-11.454), P < 0.05].
CONCLUSION
HR-VWI can clearly show the morphology and signal characteristics of intracranial vascular walls and plaques. Intracranial atherosclerotic plaques in diabetic patients are more likely to show PR, suggesting poor plaque stability and a greater risk of stroke.
Core Tip: High-resolution vessel wall imaging provides clear visualization of intracranial vascular walls and plaques. Diabetic patients with intracranial atherosclerotic plaques are more likely to display positive remodelling, indicating unstable plaques and a heightened risk of stroke. These findings contribute to the basis for preventing ischaemic stroke.
