1
|
Xia J, Yu C, Li L, Pan J. Arterial transit artifacts and carotid Plaque-RADS may predict symptoms in patients with carotid stenosis. Magn Reson Imaging 2024; 111:131-137. [PMID: 38703972 DOI: 10.1016/j.mri.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
AIM To analyze the correlation of carotid stenosis severity, the Plaque Reporting and Data System (RADS) score, arterial transit artifacts (ATAs), and cerebral blood flow (CBF) with clinical cerebral ischemic symptoms in patients with carotid artery stenosis (CAS). MATERIALS AND METHODS Sixty-one patients with unilateral internal carotid artery stenosis or occlusion (≥50% stenosis) diagnosed by ultrasound, Computed Tomography(CT) angiography, or Magnetic Resonance(MR) angiography in Yichang City Central People's Hospital from January 2022 to February 2024 were retrospectively enrolled and divided into two groups according to the presence or absence of symptoms. Both groups underwent MR plaque imaging and arterial spin labeling (ASL)-based 3.0 T MRI to compare the differences in stenosis degree, Plaque-RADS score, ATA grade, and CBF between the two groups. Binary regression analysis was used to identify the parameters with statistically significant differences between the two groups and to evaluate their diagnostic efficacy using the area under the workup curve of the subjects. RESULTS The Plaque-RADS score, ATA grade, and CBF differences in the anterior cerebral artery(ACA)blood supply region were correlated with symptoms, and the areas under the ROC curves for the CBF differences in the ACA blood supply region, Plaque-RADS score, ATA grade and a joint model that combines all three to predict symptoms in CAS patients were 0.672, 0.796, 0.788 and 0.919, respectively. CONCLUSIONS CBF, Plaque-RADS and ATAs were identified as independent risk factors for symptoms in patients with CAS and have a certain predictive value for symptoms, and the combined predictive value is greater, potentially providing a more effective imaging modality for clinical treatment and evaluation.
Collapse
Affiliation(s)
- Juan Xia
- The First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
| | - Chengxin Yu
- The First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China.
| | - Liang Li
- Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
| | - Junlong Pan
- Department of Radiology, Yichang Central People's Hospital, Yichang, Hubei, China
| |
Collapse
|
2
|
Saba L, Cau R, Murgia A, Nicolaides AN, Wintermark M, Castillo M, Staub D, Kakkos SK, Yang Q, Paraskevas KI, Yuan C, Edjlali M, Sanfilippo R, Hendrikse J, Johansson E, Mossa-Basha M, Balu N, Dichgans M, Saloner D, Bos D, Jager HR, Naylor R, Faa G, Suri JS, Costello J, Auer DP, Mcnally JS, Bonati LH, Nardi V, van der Lugt A, Griffin M, Wasserman BA, Kooi ME, Gillard J, Lanzino G, Mikhailidis DP, Mandell DM, Benson JC, van Dam-Nolen DHK, Kopczak A, Song JW, Gupta A, DeMarco JK, Chaturvedi S, Virmani R, Hatsukami TS, Brown M, Moody AR, Libby P, Schindler A, Saam T. Carotid Plaque-RADS: A Novel Stroke Risk Classification System. JACC Cardiovasc Imaging 2024; 17:62-75. [PMID: 37823860 DOI: 10.1016/j.jcmg.2023.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Carotid artery atherosclerosis is highly prevalent in the general population and is a well-established risk factor for acute ischemic stroke. Although the morphological characteristics of vulnerable plaques are well recognized, there is a lack of consensus in reporting and interpreting carotid plaque features. OBJECTIVES The aim of this paper is to establish a consistent and comprehensive approach for imaging and reporting carotid plaque by introducing the Plaque-RADS (Reporting and Data System) score. METHODS A panel of experts recognized the necessity to develop a classification system for carotid plaque and its defining characteristics. Using a multimodality analysis approach, the Plaque-RADS categories were established through consensus, drawing on existing published reports. RESULTS The authors present a universal classification that is applicable to both researchers and clinicians. The Plaque-RADS score offers a morphological assessment in addition to the prevailing quantitative parameter of "stenosis." The Plaque-RADS score spans from grade 1 (indicating complete absence of plaque) to grade 4 (representing complicated plaque). Accompanying visual examples are included to facilitate a clear understanding of the Plaque-RADS categories. CONCLUSIONS Plaque-RADS is a standardized and reliable system of reporting carotid plaque composition and morphology via different imaging modalities, such as ultrasound, computed tomography, and magnetic resonance imaging. This scoring system has the potential to help in the precise identification of patients who may benefit from exclusive medical intervention and those who require alternative treatments, thereby enhancing patient care. A standardized lexicon and structured reporting promise to enhance communication between radiologists, referring clinicians, and scientists.
Collapse
Affiliation(s)
- Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy.
| | - Riccardo Cau
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | | | - Andrew N Nicolaides
- Vascular Screening and Diagnostic Centre, Nicosia, Cyprus; University of Nicosia Medical School, Nicosia, Cyprus; Department of Vascular Surgery, Imperial College, London, United Kingdom
| | - Max Wintermark
- Department of Neuroradiology, The University of Texas MD Anderson Center, Houston, Texas, USA
| | - Mauricio Castillo
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daniel Staub
- Vascular Medicine/Angiology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Stavros K Kakkos
- Department of Vascular Surgery, University of Patras Medical School, Patras, Greece
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | | | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Myriam Edjlali
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, CEA, CNRS, Inserm, Frédéric Joliot Hospital Department, Orsay, France; Department of Radiology, APHP, Paris, France
| | | | | | - Elias Johansson
- Clinical Science, Umeå University, Neurosciences, Umeå, Sweden
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Niranjan Balu
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA
| | - Daniel Bos
- Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Clinical Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - H Rolf Jager
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
| | - Ross Naylor
- The Leicester Vascular Institute, Glenfield Hospital, Leicester, United Kingdom
| | - Gavino Faa
- Department of Pathology, University of Cagliari, Cagliari, Italy
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoin, Roseville, California, USA
| | - Justin Costello
- Department of Neuroradiology, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - J Scott Mcnally
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Leo H Bonati
- Department of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Valentina Nardi
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maura Griffin
- Vascular Screening and Diagnostic Centre, Nicosia, Cyprus
| | - Bruce A Wasserman
- Department of Radiology, University of Maryland School of Medicine and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - M Eline Kooi
- Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Giuseppe Lanzino
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London School, University College London, London, United Kingdom
| | - Daniel M Mandell
- Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - John C Benson
- Department of Radiology Mayo Clinic, Rochester, Minnesota, USA
| | - Dianne H K van Dam-Nolen
- Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anna Kopczak
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany
| | - Jae W Song
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ajay Gupta
- Department of Radiology Weill Cornell Medical College, New York, New York, USA
| | - J Kevin DeMarco
- Walter Reed National Military Medical Center and Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Seemant Chaturvedi
- Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Renu Virmani
- Department of Cardiovascular Pathology, CVPath Institute, Gaithersburg, Maryland, USA
| | | | - Martin Brown
- Department of Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Alan R Moody
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Peter Libby
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Andreas Schindler
- Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Saam
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany; Die Radiologie, Rosenheim, Germany
| |
Collapse
|