Predictive Value of Multimodal Magnetic Resonance Imaging in the Progression of TIA Patients

Ru ZHENG; Lei LI; Yongli FENG

doi:10.12259/j.issn.2095-610X.S20250719

Volume 46 Issue 7

Jul. 2025

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Ru ZHENG, Lei LI, Yongli FENG. Predictive Value of Multimodal Magnetic Resonance Imaging in the Progression of TIA Patients[J]. Journal of Kunming Medical University, 2025, 46(7): 155-162. doi: 10.12259/j.issn.2095-610X.S20250719

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Ru ZHENG, Lei LI, Yongli FENG. Predictive Value of Multimodal Magnetic Resonance Imaging in the Progression of TIA Patients[J]. Journal of Kunming Medical University, 2025, 46(7): 155-162. doi: 10.12259/j.issn.2095-610X.S20250719

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Predictive Value of Multimodal Magnetic Resonance Imaging in the Progression of TIA Patients

doi: 10.12259/j.issn.2095-610X.S20250719

Department of Imaging，The First Affiliated Hospital of Kangda College，Nanjing Medical University/Lianyungang First People’s Hospital，Lianyungang Jiangsu 222000，China

Received Date: 2024-05-06
Publish Date: 2025-07-21

Abstract

Abstract

Objective To investigate the predictive value of multimodal magnetic resonance imaging （MRI） in the progression of transient ischemic attack （TIA） patients. Methods A retrospective study was conducted on 103 TIA patients admitted to the First Affiliated Hospital of Kangda College, Nanjing Medical University （Lianyungang First People’ s Hospital） from September 2021 to December 2023. These patients were divided into the TIA group （34 cases） and the ACI group （69 cases） based on whether they progressed to acute cerebral infarction （ACI）. All patients underwent multimodal magnetic resonance examinations after admission. The imaging results of the cranial T₁WI, T₂WI, DWI, TOF-MRA, high-resolution magnetic resonance imaging, and magnetic resonance imaging perfusion-weighted imaging [plaque burden, stenosis degree, enhancement index, pial collateral grading, cerebral blood flow （CBF）, cerebral blood volume （CBV）, mean transit time （MTT）, and time to peak （TTP）] were compared between the two groups. The correlation between multimodal MRI findings and ACI risk, as well as their predictive value for ACI, were analyzed. Additionally, multimodal MRI results were compared among patients with different degrees of neurological deficits and different prognoses. Results The ACI group exhibited higher plaque load, stenosis degree, enhancement index, MTT and TTP, worse pIA collateral grade, and lower CBF and CBV compared to the TIA group （P < 0.05）. Logistic regression analysis revealed that plaque burden, stenosis degree, enhancement index, MTT, and TTP were associated risk factors for disease progression in TIA patients （OR value > 1, P < 0.001）, while pial collateral grade, CBF, and CBV were associated protective factors for disease progression in TIA patients （OR value < 1, P < 0.001）. ROC curve showed that the AUC of ACI predicted by combination of plaque load, stenosis degree, enhancement index, MTT, TTP, pia collateral grade, CBF and CBV was 0.914 （95%CI: 0.842～0.960）, which was greater than that of pia collateral grade alone（Z = 0.314, P < 0.05）.Bootstrap internal validation showed that the joint prediction results were well aligned with the ideal curve, indicating that the predicted incidence of ACI was consistent with the actual incidence. The plaque load, stenosis degree, enhancement index, MTT and TTP of patients with severe neurological deficits were higher than those with mild to moderate deficits, and CBF and CBV were lower than those of mild to moderate patients （P < 0.05）. The plaque load, stenosis degree, enhancement index, MTT and TTP of patients with poor prognosis were highe, and CBF and CBV were lower than those of with good prognosis （P < 0.05）. Conclusion Multimodal MRI has certain predictive value for the disease progression in TIA patients, providing a reference for clinical assessment of the condition and prognosis prediction, and helping to formulate targeted follow-up intervention plans.

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References(28)

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