Document Detail


Carotid plaques in transient ischemic attack and stroke patients: one-year follow-up study by magnetic resonance imaging.
MedLine Citation:
PMID:  20829705     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the natural course of carotid plaque progression in transient ischemic attack/stroke patients by using serial multisequence magnetic resonance imaging (MRI).
MATERIALS AND METHODS: Forty transient ischemic attack/stroke patients with ipsilateral <70% carotid stenosis underwent MRI of the plaque ipsilateral to the symptomatic side at baseline and after 1 year. The MRI protocol consisted of T1-weighted turbo field-echo, time-of-flight, T2-weighted turbo spin-echo (TSE), and pre- and postgadopentetate dimeglumine-enhanced T1-weighted TSE images. For each plaque, carotid lumen volume, wall volume, total vessel volume (=carotid lumen volume + wall volume), the presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and the presence of intraplaque hemorrhage (IPH) were assessed at both time points.
RESULTS: Over a 1-year period, mean carotid lumen volume decreased with 4.8% ± 2.0% (±standard error) (P = 0.013). Mean wall volume increased with 11.2% ± 2.2% (P < 0.001). Total vessel volume did not significantly change (P = 0.147). At baseline, there were 18 plaques with a LRNC, which also had a LRNC at 1-year follow-up. No plaque without a LRNC at baseline developed a LRNC during the follow-up period. All plaques with a LRNC had a thin and/or ruptured FC at both time points. Twelve patients had IPH both at baseline and at follow-up. In one patient, IPH disappeared, whereas in another patient, new IPH appeared at follow-up. The presence of IPH and a LRNC with a thin and/or ruptured FC were not significantly associated with plaque progression (P > 0.05).
CONCLUSIONS: In symptomatic patients with an ipsilateral carotid plaque causing <70% stenosis, we found evidence for inward plaque remodeling over a 1-year period. Overall, the presence/absence of IPH, a LRNC, and FC status did not change over 1 year.
Authors:
Robert M Kwee; Robert J van Oostenbrugge; Werner H Mess; Martin H Prins; Rob J van der Geest; Johannes W M ter Berg; Cees L Franke; Arthur G G C Korten; Bé J Meems; Jos M A van Engelshoven; Joachim E Wildberger; Marianne Eline Kooi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Investigative radiology     Volume:  45     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-06-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.
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