| High-resolution magnetic resonance imaging-based biomechanical stress analysis of carotid atheroma: a comparison of single transient ischaemic attack, recurrent transient ischaemic attacks, non-disabling stroke and asymptomatic patient groups. | |
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MedLine Citation:
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PMID: 20951614 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Vulnerable carotid plaques are associated with cerebrovascular ischaemic events. High-resolution magnetic resonance (MR) imaging not only allows the morphological assessment of such plaques, but also provides geometrical data, which can be used for biomechanical stress analysis. We assess its utility to assess the plaque stress profiles of symptomatic (transient ischaemic attack (TIA) and non-disabling stroke) and asymptomatic patients. METHODS: A total of 70 consecutive patients with confirmed underlying carotid artery disease underwent carotid MR imaging of their carotid artery in a 1.5-T MR system using a standard carotid atheroma imaging protocol. MR images were manually segmented for different plaque components and used for biomechanical stress analysis. The maximum critical stress (M-CStress) for various clinical groups was determined and compared. RESULTS: M-CStress of symptomatic plaques (n = 45) was significantly higher than for asymptomatic plaques (n = 25) (median (interquartile range (IQR): 275 kPa (190-390) vs. 165 kPa (120-200), p = 0.0001)). Within the symptomatic group, no M-CStress differences were present between the TIA (n = 30) and stroke (n = 15) patients (260 kPa (190-370) vs. 295 kPa (200-510), p = 0.31). Within the TIA patient cohort, those who had presented with recurrent TIAs (n = 6) had significantly higher stresses than patients who had suffered a single episode (n = 24) (425 kPa (285-580) vs. 250 kPa (180-310), p = 0.001). CONCLUSIONS: Symptomatic carotid plaques, particularly those associated with recurrent TIAs, have high biomechanical stresses. As there is pre-existing evidence to suggest that high biomechanical stresses are associated with plaque vulnerability, MR-imaging-based stress analysis has the potential to identify high-risk patients with vulnerable plaques. |
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Authors:
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U Sadat; Z Teng; V E Young; M J Graves; M E Gaunt; J H Gillard |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-16 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 41 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 83-90 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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University Department of Radiology, University of Cambridge, Cambridge, UK. us229@cam.ac.uk |
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ID/Acronym/Agency:
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//Medical Research Council |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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