High-resolution Magnetic Resonance Imaging of Intracranial Atherosclerotic Plaques in Ischemic Stroke

Study Overview
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Brief Summary
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Intracranial atherosclerotic disease is the most common cause of ischemic stroke in Asia, also in China. Currently, despite vascular recanalization therapy, statins are one of the main drug choices for treating atherosclerotic plaque. High resolution magnetic resonance imaging (HRMRI) can accurately assess the status of intracranial and extracranial arterial plaque, and has high consistency with histopathology. Thus, HRMRI technology has been widely used to monitor the efficacy of drug treatment for atherosclerotic plaque in clinical trials or practice. As a non-invasive technique, HRMRI make it possible to assess the morphologic characteristics of vascular wall and plaque composition of intracranial artery in vivo. It can quantitative analysis including components such as lipid-rich necrotic core, fiber cap thickness, intra-plaque hemorrhage, calcification, etc. Therefore, it is crucial for evaluating the etiology of ischemic stroke and developing secondary prevention strategies. At present, there is a lack of large-scale and prospective study to evaluate the etiology of ischemic stroke including cryptogenic stroke based on HRMRI. In this context, this study aims to establish a multi center HRMRI database of intracranial arteries among Chinese patients with ischemic stroke.

Official Title
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High-resolution Magnetic Resonance Imaging of Intracranial Atherosclerotic Plaques in Ischemic Stroke (HRMRI-ICAS): a Prospective, Multicenter Cohort Study

Conditions
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Stroke, Intracranial Atherosclerosis, High Resolution Magnetic Resonance Imaging

Intervention / Treatment
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* Other: Registration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Patient age ≥40 years 2. Time of stroke onset: within 2 week 3. Baseline NIHSS score ≤16 4. Ischemic stroke confirmed by head CT or MRI 5. Premorbid mRS ≤1 6. The degree of stenosis of extracranial arteries including internal carotid artery, vertebral artery on the lesion side ≤50% 7. The culprit plaque or possible culprit plaque with plaque burden of 40% or more found by HRMRI in the proximal part of the middle cerebral artery M1 segment or basilar artery of ipsilateral lesion 8. Signed informed consent Exclusion Criteria: 1. Intracranial hemorrhage found by head CT 2. Had a contraindication to MRI,or could not complete required MRI sequences 3. Intracranial tumor, arteriovenous malformation, or aneurysm 4. Comorbidity with any serious diseases and life expectancy is less than one year 5. Pregnancy 6. Patients not suitable for this clinical studies considered by researcher

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Registration|collect clinical date, assess the morphologic characteristics of plaque|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recurrence of stroke | including ischemic or hemorrhagic stroke | 360 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recurrence of stroke | including ischemic or hemorrhagic stroke | 90 days, 180 days | 
| the composite events of cardiovascular events | Cardiovascular events include cardiovascular death, stroke, non-fatal myocardial infarction, and arterial revascularization | 90 days, 180 days, 360 days | 
| distribution of modified Rankin Scale (mRS) score | mRS score range from 0 to 6: 0 [no symptoms] to 6 [death] | 90 days, 180 days 360 days | 
| The relationship between characteristics of intracranial plaques and functional independence | characteristics of intracranial plaques includes plaque composition, location and morphology; functional independence is defined as modified Rankin Scale (mRS) score 0-1 (mRS score range from 0 to 6: 0 [no symptoms] to 6 [death]) | 90 days, 180 days, 360 days | 
| The relationship between burden of cerebral small vessel disease and functional independence | burden of cerebral small vessel disease ranges from 0 to 4, with higher scores indicating greater burden; functional independence is defined as modified Rankin Scale (mRS) score 0-1 (mRS score range from 0 to 6: 0 [no symptoms] to 6 [death]) | 90 days, 180 days, 360 days |