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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1514679
This article is part of the Research Topic Bridging Gaps in Neuroimaging: Enhancing Diagnostic Precision in Cerebrovascular Disease View all 14 articles
Distinguishing Stroke from Transient ischemic attack Using Plaque Characteristics and Arterial Transit Artifacts
Provisionally accepted
Ling Li 1*
Peichun Pan 2 Na Zhang 1 Yu Wen 1
Min Tang 1 Kai Ai 3 Xiaoling Zhang 1 Xiaoyan Lei 1
Xuejiao Yan 1*- 1 Shaanxi Provincial People's Hospital, Xi'an, China
- 2 Faculty of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China
- 3 Department of Clinical Science, Philips Healthcare, Xi’an, China
Purpose: We aimed to investigate the differences in plaque characteristics andhemodynamics in patients with ischemic stroke and transient ischemic attack (TIA),comparing the diagnostic abilities of high-resolution magnetic resonance imaging(HRMRI) and arterial spin labeling (ASL) for ischemic stroke.Methods: This retrospective analysis included patients who underwent HRMRI andASL between October 2020 and December 2023. We compared clinical risk factors,vascular plaque characteristics, and the presence of arterial transit artifacts (ATAs) atpost-labeling delays (PLDs) of 1.5 s and 2.5 s between stroke and TIA groups.Multivariate logistic regression analysis was used to evaluate the diagnosticperformance of different prediction models combining clinical factors, differentialplaque characteristics, and the presence of PLD ATAs.Results: 147 patients (mean age, 57.12 ± 13.08 years; 102 men) were initiallyincluded in this study, divided into stroke (79) and TIA (68) groups. Significantdifferences in vascular positive remodeling, intraplaque hemorrhage, enhancementratio and the presence of 1.5-s and 2.5-s ATAs (p < 0.05) were observed betweengroups. Combined HRMRI and ASL performed best in distinguishing ischemic strokeand TIA(area under the curve [AUC], 0.926; 95% confidence interval [CI],0.885−0.967),withnosignificantdifferenceinischemicstrokediagnosticperformance between HRMRI and ASL (95% CI, -0.039 to 0.087, Z = 0.742, p =0.458).Conclusion: A model combined with plaque characteristics and ATAs showed gooddiagnostic performance in distinguishing between TIA and stroke in patients withintracranial atherosclerotic stenosis. ASL provides a simpler imaging evaluationmethod than HRMRI, and ATAs evaluation may become a more widely used imagingmarker in clinical practice.
Keywords: Arterial Spin Labeling, Arterial transit artifacts, high-resolution MRI, transient ischemic attack, Stroke
Received: 21 Oct 2024; Accepted: 27 Feb 2025.
Copyright: © 2025 Li, Pan, Zhang, Wen, Tang, Ai, Zhang, Lei and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ling Li, Shaanxi Provincial People's Hospital, Xi'an, China
Xuejiao Yan, Shaanxi Provincial People's Hospital, Xi'an, China
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