Table_1_The fibrinogen-to-albumin ratio is associated with intracranial atherosclerosis plaque enhancement on contrast-enhanced high-resolution magnetic resonance imaging.docx

BackgroundContrast-enhanced high-resolution magnetic resonance imaging (CE-HR-MRI) is a useful imaging modality to assess vulnerable plaques in intracranial atherosclerotic stenosis (ICAS) patients. We studied the relationship between the fibrinogen-to-albumin ratio (FAR) and plaque enhancement in patients with ICAS.
MethodsWe retrospectively enrolled consecutive ICAS patients who had undergone CE-HR-MRI. The degree of plaque enhancement on CE-HR-MRI was evaluated both qualitatively and quantitatively. Enrolled patients were classified into no enhancement, mild enhancement, and obvious enhancement groups. An independent association of the FAR with plaque enhancement was identified by multivariate logistic regression and receiver operating characteristic (ROC) curve analyses.
ResultsOf the 69 enrolled patients, 40 (58%) were classified into the no/mild enhancement group, and 29 (42%) into the obvious enhancement group. The obvious enhancement group had a significantly higher FAR than the no/mild enhancement group (7.36 vs. 6.05, p = 0.001). After adjusting for potential confounders, the FAR was still significantly independently associated with obvious plaque enhancement in multiple regression analysis (odds ratio: 1.399, 95% confidence interval [CI]: 1.080–1.813; p = 0.011). ROC curve analysis revealed that FAR >6.37 predicted obvious plaque enhancement with 75.86% sensitivity and 67.50% specificity (area under the ROC curve = 0.726, 95% CI: 0.606–0.827, p < 0.001).
ConclusionThe FAR can serve as an independent predictor of the degree of plaque enhancement on CE-HR-MRI in patients with ICAS. Also, as an inflammatory marker, the FAR has potential as a serological biomarker of intracranial atherosclerotic plaque vulnerability.

背景 对比增强高分辨率磁共振成像（contrast-enhanced high-resolution magnetic resonance imaging, CE-HR-MRI）是评估颅内动脉粥样硬化狭窄（intracranial atherosclerotic stenosis, ICAS）患者易损斑块的有效成像技术。本研究探讨了颅内动脉粥样硬化狭窄患者的纤维蛋白原-白蛋白比值（fibrinogen-to-albumin ratio, FAR）与斑块强化程度之间的关联。
方法 本研究回顾性纳入连续入组的、接受过CE-HR-MRI检查的ICAS患者。对CE-HR-MRI图像上的斑块强化程度分别进行定性与定量评估。将入组患者分为无强化组、轻度强化组及明显强化组。通过多因素logistic回归分析与受试者工作特征（receiver operating characteristic, ROC）曲线分析，明确FAR与斑块强化程度的独立关联。
结果 本研究共纳入69例患者，其中40例（58%）归入无/轻度强化组，29例（42%）归入明显强化组。明显强化组的FAR显著高于无/轻度强化组（7.36 vs. 6.05，p=0.001）。在校正潜在混杂因素后，多因素回归分析显示FAR仍与斑块明显强化存在显著独立关联（优势比：1.399，95%置信区间[CI]：1.080–1.813；p=0.011）。ROC曲线分析显示，当FAR>6.37时，预测斑块明显强化的灵敏度为75.86%，特异度为67.50%（ROC曲线下面积=0.726，95%CI：0.606–0.827，p<0.001）。
结论 FAR可作为ICAS患者CE-HR-MRI斑块强化程度的独立预测因子。此外，作为一种炎症标志物，FAR有望成为颅内动脉粥样硬化斑块易损性的血清学生物标志物。