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Huang LX, Wu XB, Liu YA, Guo X, Liu CC, Cai WQ, Wang SW, Luo B. High-resolution magnetic resonance vessel wall imaging in ischemic stroke and carotid artery atherosclerotic stenosis: A review. Heliyon 2024; 10:e27948. [PMID: 38571643 PMCID: PMC10987942 DOI: 10.1016/j.heliyon.2024.e27948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/02/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
Ischemic stroke is a significant burden on human health worldwide. Carotid Atherosclerosis stenosis plays an important role in the comprehensive assessment and prevention of ischemic stroke patients. High-resolution vessel wall magnetic resonance imaging has emerged as a successful technique for assessing carotid atherosclerosis stenosis. This advanced imaging modality has shown promise in effectively displaying a wide range of characteristics associated with the condition, leading to a comprehensive evaluation. High-resolution vessel wall magnetic resonance imaging not only enables a comprehensive evaluation of the instability of carotid atherosclerosis stenosis plaques but also provides valuable information for understanding the pathogenesis and predicting the prognosis of ischemic stroke patients. The purpose of this article is to review the application of high-resolution magnetic resonance imaging in ischemic stroke and carotid atherosclerotic stenosis.
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Affiliation(s)
- Li-Xin Huang
- Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xiao-Bing Wu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi-Ao Liu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Xin Guo
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Chi-Chen Liu
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Wang-Qing Cai
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sheng-Wen Wang
- Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Luo
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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Canton G, Hippe DS, Chen L, Waterton JC, Liu W, Watase H, Balu N, Sun J, Hatsukami TS, Yuan C. Atherosclerotic Burden and Remodeling Patterns of the Popliteal Artery as Detected in the Magnetic Resonance Imaging Osteoarthritis Initiative Data Set. J Am Heart Assoc 2021; 10:e018408. [PMID: 33998279 PMCID: PMC8483503 DOI: 10.1161/jaha.120.018408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background An artificial intelligence vessel segmentation tool, Fully Automated and Robust Analysis Technique for Popliteal Artery Evaluation (FRAPPE), was used to analyze a large databank of popliteal arteries imaged through the OAI (Osteoarthritis Initiative) to study the impact of atherosclerosis risk factors on vessel dimensions and characterize remodeling patterns. Methods and Results Magnetic resonance images from 4668 subjects contributing 9189 popliteal arteries were analyzed using FRAPPE. Age ranged from 45 to 79 years (median, 61), and 58% were women. Mean lumen diameter, mean outer wall diameter, and mean wall thickness (MWT) were measured per artery. Their median values were 5.8 mm (interquartile range, 5.2–6.5 mm), 7.3 mm (interquartile range, 6.7–8.1 mm), and 0.78 mm (interquartile range, 0.73–0.84 mm) respectively. MWT was associated with multiple cardiovascular risk factors, with age (4.2% increase in MWT per 10‐year increase in age; 95% CI, 3.9%–4.5%) and sex (8.6% higher MWT in men than women; 95% CI, 7.7%–9.3%) being predominant. On average, lumen and outer wall diameters increased with increasing MWT until the thickness was 0.92 mm for men and 0.84 mm for women. After this point, lumen diameter decreased steadily, more rapidly in men than women (−7.9% versus −6.1% per 25% increase in MWT; P<0.001), with little change in outer wall diameter. Conclusions FRAPPE has enabled the analysis of the large OAI knee magnetic resonance imaging data set, successfully showing that popliteal atherosclerosis is predominantly associated with age and sex. The average vessel remodeling pattern consisted of an early phase of compensatory enlargement, followed by a negative remodeling, which is more pronounced in men.
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Affiliation(s)
- Gador Canton
- Department of RadiologyUniversity of WashingtonSeattleWA
| | | | - Li Chen
- Department of Electrical and Computer EngineeringUniversity of WashingtonSeattleWA
| | - John C. Waterton
- Centre for Imaging SciencesManchester Academic Health Science CentreThe University of ManchesterUnited Kingdom
| | - Wenjin Liu
- Department of RadiologyUniversity of WashingtonSeattleWA
| | - Hiroko Watase
- Department of SurgeryUniversity of WashingtonSeattleWA
| | - Niranjan Balu
- Department of RadiologyUniversity of WashingtonSeattleWA
| | - Jie Sun
- Department of RadiologyUniversity of WashingtonSeattleWA
| | | | - Chun Yuan
- Department of RadiologyUniversity of WashingtonSeattleWA
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Bytyçi I, Shenouda R, Wester P, Henein MY. Carotid Atherosclerosis in Predicting Coronary Artery Disease: A Systematic Review and Meta-Analysis. Arterioscler Thromb Vasc Biol 2021; 41:e224-e237. [PMID: 33626907 DOI: 10.1161/atvbaha.120.315747] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Ibadete Bytyçi
- Institute of Public Health and Clinical Medicine, Umeå University, Sweden (I.B., R.S., P.W., M.Y.H.).,Clinic of Cardiology, University Clinical Centre of Kosovo and Universi College, Prishtina (I.B.)
| | - Rafik Shenouda
- Institute of Public Health and Clinical Medicine, Umeå University, Sweden (I.B., R.S., P.W., M.Y.H.).,International Cardiac Centre-ICC and Alexandria University, Egypt (R.S.)
| | - Per Wester
- Institute of Public Health and Clinical Medicine, Umeå University, Sweden (I.B., R.S., P.W., M.Y.H.)
| | - Michael Y Henein
- Institute of Public Health and Clinical Medicine, Umeå University, Sweden (I.B., R.S., P.W., M.Y.H.).,Molecular and Clinic Research Institute, St George University, London, and Brunel University, United Kingdom (M.Y.H.)
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Evolving determinants of carotid atherosclerosis vulnerability in asymptomatic patients from the MAGNETIC observational study. Sci Rep 2021; 11:2327. [PMID: 33504842 PMCID: PMC7840938 DOI: 10.1038/s41598-021-81247-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 12/28/2020] [Indexed: 11/08/2022] Open
Abstract
MRI can assess plaque composition and has demonstrated an association between some atherosclerotic risk factors (RF) and markers of plaque vulnerability in naive patients. We aimed at investigating this association in medically treated asymptomatic patients. This is a cross-sectional interim analysis (August 2013-September 2016) of a single center prospective study on carotid plaque vulnerability (MAGNETIC study). We recruited patients with asymptomatic carotid atherosclerosis (US stenosis > 30%, ECST criteria), receiving medical treatments at a tertiary cardiac rehabilitation. Atherosclerotic burden and plaque composition were quantified with 3.0 T MRI. The association between baseline characteristics and extent of lipid-rich necrotic core (LRNC), fibrous cap (CAP) and intraplaque hemorrhage (IPH) was studied with multiple regression analysis. We enrolled 260 patients (198 male, 76%) with median age of 71-y (interquartile range: 65-76). Patients were on antiplatelet therapy, ACE-inhibitors/angiotensin receptor blockers and statins (196-229, 75-88%). Median LDL-cholesterol was 78 mg/dl (59-106), blood pressure 130/70 mmHg (111-140/65-80), glycosylated hemoglobin 46 mmol/mol (39-51) and BMI 25 kg/m2 (23-28); moreover, 125 out of 187 (67%) patients were ex-smokers. Multivariate analysis of a data-set of 487 (94%) carotid arteries showed that a history of hypercholesterolemia, diabetes, hypertension or smoking did not correlate with LRNC, CAP or IPH. Conversely, maximum stenosis was the strongest independent predictor of LRNC, CAP and IPH (p < 0.001). MRI assessment of plaque composition in patients on treatment for asymptomatic carotid atherosclerosis shows no correlation between plaque vulnerability and the most well-controlled modifiable RF. Conversely, maximum stenosis exhibits a strong correlation with vulnerable features despite treatment.
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Liu W, Balu N, Canton G, Hippe DS, Watase H, Waterton JC, Hatsukami T, Yuan C. Understanding Atherosclerosis Through an Osteoarthritis Data Set. Arterioscler Thromb Vasc Biol 2020; 39:1018-1025. [PMID: 31070477 DOI: 10.1161/atvbaha.119.312513] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Atherosclerotic cardiovascular disease remains a worldwide epidemic and one of the leading causes of death nowadays. Vessel wall imaging can be used to understand the development and progression of atherosclerosis, but it is rarely done because of the high cost. We recently identified the Osteoarthritis Initiative, a large prospective cohort study of knee osteoarthritis, which might serve as a valuable source for atherosclerosis research with its serial knee magnetic resonance imaging data. We have found that these images are suitable for vessel wall image analysis of the lower extremity arteries. Here, we will introduce the Osteoarthritis Initiative data set and explain why it could be used for cardiovascular research purposes. Also, we will briefly comment on peripheral artery atherosclerosis as it is covered in the Osteoarthritis Initiative image data set and review the use of vessel wall imaging for studying atherosclerosis. We think data mining of imaging studies, not originally designed on cardiovascular research, can not only maximize the value of the imaging data set but also boost our understanding of atherosclerosis.
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Affiliation(s)
- Wenjin Liu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Niranjan Balu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Gador Canton
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Daniel S Hippe
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Hiroko Watase
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - John C Waterton
- Centre for Imaging Sciences, Manchester Academic Health Science Centre, The University of Manchester, United Kingdom (J.C.W.)
| | - Thomas Hatsukami
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - Chun Yuan
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
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Saba L, Lai L, Lucatelli P, Sanfilippo R, Montisci R, S Suri J, Faa G. Association between carotid artery plaque inflammation and brain MRI. J Neuroradiol 2018; 47:203-209. [PMID: 30439395 DOI: 10.1016/j.neurad.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/10/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To explore the association between presence of inflammatory cells in the carotid plaques surgically treated and brain MRI findings. MATERIAL AND METHODS Forty consecutive patients were prospectively analyzed. Brain MRI was performed with a 1.5 Tesla scanner and infacts (lacuna and non-lacunar) pertinence of the anterior circulation were recorded. All patients underwent carotid endarterectomy "en bloc"; carotid plaques histological sections were prepared and immuno-cytochemical analysis was performed to characterize and quantify the presence of inflammatory cells. ROC curve analysis, Pearson Rho correlation and Mann-Whitney test were applied. RESULTS The immuno-cytochemical analysis demonstrated that plaques of symptomatic patients (stroke\TIA; n = 25) had more inflammatory cells, mainly macrophages (CD68) compared with plaques of patients without symptoms (Mann-Whitney = P < 0.001, ROC curve area = 0.901). Correlation analysis showed a statistically significant association between the number of brain non-lacunar infarcts and the entity of macrophages (P < 0.001); whereas no association with lacunar infarcts (P = 0.1934) was found. CONCLUSION Results of this preliminary study suggest that the presence and amount of inflammatory cells within carotid artery plaque is associated with cerebrovascular events and with the number of MRI brain detectable infarct.
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Affiliation(s)
- Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy.
| | - Letizia Lai
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato. ss. 554 Monserrato (Cagliari) 09045, Italy
| | | | - Roberto Sanfilippo
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy
| | - Roberto Montisci
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy
| | - Jasjit S Suri
- Diagnostic and monitoring division AtheroPoint, Roseville, CA, USA
| | - Gavino Faa
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato. ss. 554 Monserrato (Cagliari) 09045, Italy
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Zhang Y, Guallar E, Malhotra S, Astor BC, Polak JF, Qiao Y, Gomes AS, Herrington DM, Sharrett AR, Bluemke DA, Wasserman BA. Carotid Artery Wall Thickness and Incident Cardiovascular Events: A Comparison between US and MRI in the Multi-Ethnic Study of Atherosclerosis (MESA). Radiology 2018; 289:649-657. [PMID: 30299234 DOI: 10.1148/radiol.2018173069] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpose To compare common carotid artery (CCA) wall thickness measured manually by using US and semiautomatically by using MRI, and to examine their associations with incident coronary heart disease and stroke. Materials and Methods This prospective study enrolled 698 participants without a history of clinical cardiovascular disease (CVD) from the Multi-Ethnic Study of Atherosclerosis (MESA) from July 2000 to December 2013 (mean age, 63 years; range, 45 to 84 years; same for men and women). All participants provided written informed consent. CCA wall thickness was measured with US as well as both noncontrast proton-density-weighted and intravenous gadolinium-enhanced MRI. Cox proportional hazards models were used to assess the associations between wall thickness measurements by using US and MRI with CVD outcomes. Results The adjusted hazard ratios for coronary heart disease, stroke, and CVD associated with per standard deviation increase in intima-media thickness were 1.10, 1.08, and 1.14, respectively. The corresponding associations for mean wall thickness measured with proton-density-weighted MRI were 1.32, 1.48, and 1.37, and for mean wall thickness measured with gadolinium-enhanced MRI were 1.27, 1.58, and 1.38. When included simultaneously in the same model, MRI wall thickness, but not intima-media thickness, remained associated with outcomes. Conclusion For individuals without known cardiovascular disease at baseline, wall thickness measurements by using MRI were more consistently associated with incident cardiovascular disease, particularly stroke, than were intima-media thickness by using US. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Yiyi Zhang
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Eliseo Guallar
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Saurabh Malhotra
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Brad C Astor
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Joseph F Polak
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Ye Qiao
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Antoinette S Gomes
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - David M Herrington
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - A Richey Sharrett
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - David A Bluemke
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
| | - Bruce A Wasserman
- From the Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (Y.Z., E.G., A.R.S.); Division of Cardiovascular Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY (S.M.); Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wis (B.C.A.); Department of Radiology, Tufts University School of Medicine, Boston, Mass (J.F.P.); The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, 367 East Park Building, Baltimore, Md 21287 (Y.Q., B.A.W.); Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif (A.S.G.); Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC (D.M.H.); and Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md (D.A.B.)
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Imaging atherosclerosis in rheumatoid arthritis: evidence for increased prevalence, altered phenotype and a link between systemic and localised plaque inflammation. Sci Rep 2017; 7:827. [PMID: 28400572 PMCID: PMC5429790 DOI: 10.1038/s41598-017-00989-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/17/2017] [Indexed: 01/20/2023] Open
Abstract
In rheumatoid arthritis (RA), chronic inflammation is thought to drive increased cardiovascular risk through accelerated atherosclerosis. It may also lead to a more high-risk plaque phenotype. We sought to investigate carotid plaque phenotype in RA patients using Dynamic Contrast-Enhanced MRI (DCE-MRI) and Fludeoxyglucose Positron Emission Tomography(FDG-PET). In this pilot study, RA patients and age/sex-matched controls were evaluated for cardiovascular risk factors and carotid plaque on ultrasound. Subjects with plaque >2 mm thick underwent DCE-MRI, and a subgroup of patients had FDG-PET. Comparison of MRI findings between groups and correlation between clinical, serological markers and imaging findings was undertaken. 130 patients and 62 controls were recruited. Plaque was more prevalent in the RA group (53.1% vs 37.0%, p = 0.038) and was independently associated with IL6 levels (HR[95%CI]: 2.03 [1.26, 3.26] per quartile). DCE-MRI data were available in 15 patients and 5 controls. Higher prevalence of plaque calcification was noted in RA, despite similar plaque size (73.3% vs 20%, p = 0.04). FDG-PET detected plaque inflammation in 12/13 patients scanned and degree of inflammation correlated with hs-CRP (r = 0.58, p = 0.04). This study confirms increased prevalence of atherosclerosis in RA and provides data to support the hypothesis that patients have a high-risk plaque phenotype.
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Carmona-Rubio AE, Lee AM, Puchner S, Ghoshhajra B, Sharma UC. A review of adherence to the guidelines for coronary CT angiography quantitative stenosis grading thresholds in published research. Postgrad Med 2014; 127:194-201. [PMID: 25540988 DOI: 10.1080/00325481.2015.995065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The degree of coronary stenosis of potential hemodynamic significance is central to the interpretation of coronary computed tomography angiography (CCTA), but has been variably defined in the literature. Societal guidelines have attempted to address this issue via recommended thresholds. OBJECTIVES We surveyed the various thresholds for defining significant coronary stenosis reported in research published since the introduction of the Society for Cardiovascular Computed Tomography guidelines regarding the interpretation and reporting of CCTA. METHODS We systematically reviewed the results of bibliographic searches of all original research articles on CCTA, focusing on studies reporting > 25 subjects, to assess the definitions of severity of coronary lesions as found on CCTA. To enable comparisons, we stratified the methods of reporting lesion severity into ≥ 50%, 50% to 69%, and "others" (including infrequent reporting methods). RESULTS Fifty-nine11 published studies were identified and met inclusion criteria. Eighteen studies reported the severity of coronary stenosis using a definition of 50% to 69% as moderate stenosis; 35 studies defined ≥ 50% coronary stenosis as "stenosis," "significant stenosis," or "obstructive lesion" without distinguishing a threshold for moderate versus severe stenosis. Six studies utilized other thresholds, such as 20% to 75%, 40% to 69%, 40% to 70%, 40% to 79%, and 50% to 75% to define moderate coronary stenosis. CONCLUSIONS Fifty-three of 59 studies were graded in accordance with the recommended threshold of ≥ 50% defining potentially significant stenosis, with 18 studies reporting precisely in accordance with the guidelines-recommended thresholds of ≥ 50% narrowing as defining moderate stenosis and ≥ 70% narrowing as defining severe stenosis. Six studies were reported using alternative thresholds for significant stenosis. However, a majority of research studies published since 2009 do not follow the societal guidelines for stenosis grading, since these studies do not clearly describe the degree of coronary stenosis.
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Affiliation(s)
- Andres E Carmona-Rubio
- Department of Medicine, University at Buffalo, State University of New York, School of Medicine , Buffalo, NY
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11
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Polonsky TS, Liu K, Tian L, Carr J, Carroll TJ, Berry J, Criqui MH, Ferrucci L, Guralnik JM, Kibbe MR, Kramer CM, Li F, Xu D, Zhao X, Yuan C, McDermott MM. High-risk plaque in the superficial femoral artery of people with peripheral artery disease: prevalence and associated clinical characteristics. Atherosclerosis 2014; 237:169-76. [PMID: 25240112 DOI: 10.1016/j.atherosclerosis.2014.08.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 07/23/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We used magnetic resonance imaging (MRI) to study the prevalence and associated clinical characteristics of high-risk plaque (defined as presence of lipid-rich necrotic core [LRNC] and intraplaque hemorrhage) in the superficial femoral arteries (SFA) among people with peripheral artery disease (PAD). BACKGROUND The prevalence and clinical characteristics associated with high-risk plaque in the SFA are unknown. METHODS Three-hundred-three participants with PAD underwent MRI of the proximal SFA using a 1.5 T S platform. Twelve contiguous 2.5 mm cross-sectional images were obtained. RESULTS LRNC was present in 68 (22.4%) participants. Only one had intra-plaque hemorrhage. After adjusting for age and sex, smoking prevalence was higher among adults with LRNC than among those without LRNC (35.9% vs. 21.4%, p = 0.02). Among participants with vs. without LRNC there were no differences in mean percent lumen area (31% vs. 33%, p = 0.42), normalized mean wall area (0.71 vs. 0.70, p = 0.67) or maximum wall area (0.96 vs. 0.92, p = 0.54) in the SFA. Among participants with LRNC, cross-sectional images containing LRNC had a smaller percent lumen area (33% ± 1% vs. 39% ± 1%, p < 0.001), greater normalized mean wall thickness (0.25 ± 0.01 vs. 0.22 ± 0.01, p < 0.001), and greater normalized maximum wall thickness (0.41 ± 0.01 vs. 0.31 ± 0.01, p < 0.001), compared to cross-sectional images without LRNC. CONCLUSIONS Fewer than 25% of adults with PAD had high-risk plaque in the proximal SFA using MRI. Smoking was the only clinical characteristic associated with presence of LRNC. Further study is needed to determine the prognostic significance of LRNC in the SFA. CLINICAL TRIAL REGISTRATION-URL http://www.clinicaltrials.gov. Unique identifier: NCT00520312.
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Affiliation(s)
- Tamar S Polonsky
- Department of Medicine, University of Chicago, Chicago, IL, USA.
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Lu Tian
- Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - James Carr
- Department of Biomedical Engineering and Radiology, Northwestern University, Chicago, IL, USA.
| | - Timothy J Carroll
- Department of Biomedical Engineering and Radiology, Northwestern University, Chicago, IL, USA.
| | - Jarett Berry
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Michael H Criqui
- Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA, USA.
| | - Luigi Ferrucci
- Laboratory of Clinical Epidemiology, National Institute on Aging, Bethesda, MD, USA.
| | - Jack M Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Melina R Kibbe
- Division of Vascular Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Christopher M Kramer
- Department of Radiology and Medicine, University of Virginia Health System, Charlottesville, VA, USA.
| | - Feiyu Li
- Department of Radiology, University of Washington, Seattle, WA, USA.
| | - Dongxiang Xu
- Department of Radiology, University of Washington, Seattle, WA, USA.
| | - Xihao Zhao
- Department of Radiology, University of Washington, Seattle, WA, USA.
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA.
| | - Mary M McDermott
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
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12
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Zhang Y, Guallar E, Qiao Y, Wasserman BA. Is carotid intima-media thickness as predictive as other noninvasive techniques for the detection of coronary artery disease? Arterioscler Thromb Vasc Biol 2014; 34:1341-5. [PMID: 24764454 DOI: 10.1161/atvbaha.113.302075] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Carotid intima-media thickness (CIMT) measured by B-mode ultrasound is the most widely used noninvasive imaging method to assess atherosclerosis and cardiovascular risk. CIMT has been consistently associated with coronary artery disease and stroke; however, recent meta-analyses and systematic reviews suggest that its clinical usefulness may be limited because the addition of CIMT to traditional risk factors has not improved the risk prediction of cardiovascular events in the general population. Characterizing the carotid wall by MRI may have greater clinical utility compared with CIMT measurements by ultrasound. Unlike CIMT, MRI measurements of wall thickness include the adventitia and may be sensitive to adventitial thickening that results from vasa vasorum proliferation as a sign of early plaque development. MRI also has the ability to image the entire circumference of the carotid wall, including the outer wall of the carotid bulb where plaque forms in its earliest stage, and identify plaque components such as the lipid core, fibrous cap, and intraplaque hemorrhage that are closely related to plaque vulnerability and cardiovascular risk. Additional research is needed to assess the added prognostic value of MRI measurements of wall and plaque features in risk prediction beyond traditional risk factors.
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Affiliation(s)
- Yiyi Zhang
- From the Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (Y.Z., E.G.); and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.)
| | - Eliseo Guallar
- From the Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (Y.Z., E.G.); and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.)
| | - Ye Qiao
- From the Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (Y.Z., E.G.); and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.)
| | - Bruce A Wasserman
- From the Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (Y.Z., E.G.); and Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
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13
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Huang KL, Chang YJ, Chang CH, Chang TY, Liu CH, Hsieh IC, Wong HF, Wai YY, Chen YW, Yip BS, Lee TH. Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting. PLoS One 2014; 9:e94280. [PMID: 24732408 PMCID: PMC3986076 DOI: 10.1371/journal.pone.0094280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Coronary artery disease (CAD) may coexist with extracranial carotid artery stenosis (ECAS), but the influence of CAD on procedure-related complications after carotid artery stenting (CAS) has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI) scanning. Methods Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. Results Among 126 patients (69.5±9.0 years) recruited for unilateral protected CAS, 33 (26%) patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33) and 48% (45 in 93) of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6–10.0; P = .0018), and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032). In patients with no CAD (n = 55), asymptomatic CAD (n = 41) and symptomatic CAD (n = 30), the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048), and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120). Conclusions The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.
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Affiliation(s)
- Kuo-Lun Huang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yeu-Jhy Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hung Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Chang
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Hung Liu
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Chang Hsieh
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Internal Medicine, Section of Cardiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ho-Fai Wong
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yau-Yau Wai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Wei Chen
- Department of Neurology, Landseed Hospital, Taoyuan, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei City, Taiwan
- Department of Computer Science and Information Engineering, National Central University, Zhongli City, Taiwan
| | - Bak-Sau Yip
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Tsong-Hai Lee
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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14
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Lou X, Ma N, Ma L, Jiang WJ. Contrast-enhanced 3T high-resolution MR imaging in symptomatic atherosclerotic basilar artery stenosis. AJNR Am J Neuroradiol 2012; 34:513-7. [PMID: 22878005 DOI: 10.3174/ajnr.a3241] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced 3T high-resolution MR imaging can be used to determine the wall enhancement pattern of the basilar artery in symptomatic atherosclerotic stenosis. We used this method to explore the relationship between wall enhancement and both recent infarction in the territory of the stenotic BA and subsequent ischemic events associated with the stenotic BA. MATERIALS AND METHODS Sixty patients with symptomatic atherosclerotic BA stenosis ≥70% were enrolled consecutively. HR-MRI of cross-sectional BAs was obtained before and after contrast media injection, and wall enhancement indices were calculated for sections proximal to, at, and distal to the site of maximal luminal narrowing. DWI of the brain was performed to determine the presence of recent infarction. RESULTS Images from 56 patients were suitable for analysis. Thirty-three patients underwent stent placement for the stenotic BA, and 23 patients underwent conservative medical treatment with antiplatelet agents and risk-factor control. All 23 patients with medical treatment had a 12-month follow-up. Greater wall enhancement was seen in the section proximal to the MLN section in both patients with recent infarction (74 ± 65% versus 44 ± 44%; P = .046) and in patients with subsequent ischemic events (100 ± 57% versus 44 ± 44%; P = .014). CONCLUSIONS Greater wall enhancement proximal to the MLN site correlates with recent infarction in the territory of the stenotic BA and subsequent ischemic events associated with the stenotic BA. Contrast-enhanced HR-MRI may serve as a noninvasive tool for risk stratification of BA atherosclerosis.
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Affiliation(s)
- X Lou
- Department of Radiology, People's Liberation Army General Hospital, Beijing, China
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Liu XS, Zhao HL, Cao Y, Lu Q, Xu JR. Comparison of carotid atherosclerotic plaque characteristics by high-resolution black-blood MR imaging between patients with first-time and recurrent acute ischemic stroke. AJNR Am J Neuroradiol 2012; 33:1257-61. [PMID: 22345496 DOI: 10.3174/ajnr.a2965] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE It has been shown that patients with a first ischemic stroke are at high risk of developing recurrent stroke due to carotid atherosclerotic plaque rupture. However, no one has defined the difference in plaques between initial and recurrent stroke. This study sought to investigate the characteristics of carotid plaque between patients with first-time and recurrent acute ischemic stroke by using MR imaging. MATERIALS AND METHODS Eighty-nine patients with recent acute ischemic stroke were recruited. All subjects underwent carotid high-resolution black-blood MR imaging. The index carotid arteries, defined as the arteries responsible for the ipsilateral stroke, were analyzed quantitatively and qualitatively. Carotid plaque burden and compositional features between patients with first-time and recurrent ischemic stroke were compared. RESULTS Of 89 recruited patients, 51 had first-time stroke and 38 had recurrent stroke. The mean WA, WT, and PWV were greater in patients with recurrent stroke than in patients with first-time stroke (all, P < .05). Compared with patients with first-time stroke, those with recurrent stroke showed significantly higher prevalence of calcification (44.7% versus 23.5%, P = .035) as well as a larger volume of LRNC (179.14 ± 254.81 mm(2) versus 71.65 ± 111.15 mm(2), P = .027). IPH or fibrous cap rupture or both were observed in 15.8% of patients with recurrent stroke and 3.9% of patients with first-time stroke. CONCLUSIONS Carotid plaques in patients with recurrent ischemic stroke are significantly aggravated compared with those in patients with first-time stroke, and monitoring carotid plaques in patients with initial stroke by MR imaging may be helpful for secondary stroke prevention.
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Affiliation(s)
- X S Liu
- Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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What Will Noninvasive Carotid Atherosclerosis Imaging Show Us About High-Risk Coronary Plaques? J Am Coll Cardiol 2011; 58:423-5. [DOI: 10.1016/j.jacc.2011.02.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/22/2011] [Indexed: 11/24/2022]
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