Back to Search
Start Over
Comparison of symptomatic and asymptomatic atherosclerotic carotid plaques using parallel imaging and 3 T black-blood in vivo CMR.
- Source :
-
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance [J Cardiovasc Magn Reson] 2013 May 24; Vol. 15, pp. 44. Date of Electronic Publication: 2013 May 24. - Publication Year :
- 2013
-
Abstract
- Background: To determine if black-blood 3 T cardiovascular magnetic resonance (bb-CMR) can depict differences between symptomatic and asymptomatic carotid atherosclerotic plaques in acute ischemic stroke patients.<br />Methods: In this prospective monocentric observational study 34 patients (24 males; 70 ±9.3 years) with symptomatic carotid disease defined as ischemic brain lesions in one internal carotid artery territory on diffusion weighted images underwent a carotid bb-CMR at 3 T with fat-saturated pre- and post-contrast T1w-, PDw-, T2w- and TOF images using surface coils and Parallel Imaging techniques (PAT factor = 2) within 10 days after symptom onset. All patients underwent extensive clinical workup (lab, brain MR, duplex sonography, 24-hour ECG, transesophageal echocardiography) to exclude other causes of ischemic stroke. Prevalence of American Heart Association lesion type VI (AHA-LT6), status of the fibrous cap, presence of hemorrhage/thrombus and area measurements of calcification, necrotic core and hemorrhage were determined in both carotid arteries in consensus by two reviewers who were blinded to clinical information. McNemar and Wilcoxon's signed rank tests were use for statistical comparison. A p-value <0.05 was considered statistically significant.<br />Results: Symptomatic plaques showed a higher prevalence of AHA-LT6 (67.7% vs. 11.8%; p < 0.001; odds ratio = 12.5), ruptured fibrous caps (44.1% vs. 2.9%; p < 0.001; odds ratio = 15.0), juxtaluminal thrombus (26.5 vs. 0%; p < 0.01; odds ratio = 7.3) and intraplaque hemorrhage (58.6% vs. 11.8%; p = 0.01; odds ratio = 3.8). Necrotic core and hemorrhage areas were greater in symptomatic plaques (14.1 mm2 vs. 5.5 mm2 and 13.6 mm2 vs. 5.3 mm2; p < 0.01, respectively).<br />Conclusion: 3 T bb-CMR is able to differentiate between symptomatic and asymptomatic carotid plaques, demonstrating the potential of bb-CMR to differentiate between stable and vulnerable lesions and ultimately to identify patients with low versus high risk for cardiovascular complications. Best predictors of the symptomatic side were a ruptured fibrous cap, AHA-LT 6, juxtaluminal hemorrhage/thrombus, and intraplaque hemorrhage.
- Subjects :
- Aged
Asymptomatic Diseases
Brain Ischemia etiology
Carotid Artery Diseases complications
Carotid Artery Diseases pathology
Diagnosis, Differential
Disease Progression
Female
Fibrosis
Germany
Hemorrhage diagnosis
Hemorrhage etiology
Humans
Logistic Models
Male
Middle Aged
Necrosis
Odds Ratio
Predictive Value of Tests
Prospective Studies
Risk Factors
Rupture, Spontaneous
Stroke etiology
Carotid Artery Diseases diagnosis
Carotid Artery, Internal pathology
Diffusion Magnetic Resonance Imaging methods
Plaque, Atherosclerotic
Subjects
Details
- Language :
- English
- ISSN :
- 1532-429X
- Volume :
- 15
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
- Publication Type :
- Academic Journal
- Accession number :
- 23705576
- Full Text :
- https://doi.org/10.1186/1532-429X-15-44