Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging
Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging
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DOI：
10.1007/s00234-012-1011-2
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发表时间：
2012-01
期刊：
影响因子：
2.8
通讯作者：
M. Yamaguchi;M. Sasaki;H. Ohba;K. Mori;S. Narumi;N. Katsura;K. Ohura;K. Kudo;Y. Terayama
中科院分区：
文献类型：
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作者：
M. Yamaguchi;M. Sasaki;H. Ohba;K. Mori;S. Narumi;N. Katsura;K. Ohura;K. Kudo;Y. Terayama
西洛他唑是一种抗血小板药物，据报道可使动脉粥样硬化性病变消退。然而，其对颈动脉斑块的影响尚不清楚。因此，我们定量研究了西洛他唑管理过程中颈动脉斑块内发生的变化，使用三维（3D）超声（US）和非门控磁共振（MR）斑块imaging.MethodsWe前瞻性研究了16例连续颈动脉狭窄患者。在基线和开始西洛他唑治疗（200 mg/天）后6个月进行3D-US和T1加权MR斑块成像。我们从3D-US数据测量斑块的体积和灰度中值（GSM）。我们还计算了对比率（CR）的颈动脉斑块对邻近的肌肉和面积的intraplaque组件：纤维组织，脂质和出血component.ResultsThe斑块体积在美国显着下降（中位数在基线和6个月，0.23和0.21立方厘米，分别为P =0.03）。在斑块体积减少超过10%的组中，US上的GSM显著增加（分别为24.8和71.5;p =0.04），MRI上的CR显著降低（分别为1.13和1.04;p =0.02）。此外，在该组中，MRI上纤维成分的面积百分比显著增加（分别为68.6%和79.4%;p =0.02），而脂质和出血成分的面积百分比降低（分别为24.9%和20.5%;p =0.12）（分别为1.0%和0.0%;p =0.04）。有没有实质性的变化，无论是在US或MRI中的其他group. Conclusions 3D-US和MR斑块成像的斑块内特征可以定量检测西洛他唑治疗过程中颈动脉斑块的大小和组成的变化。
IntroductionCilostazol, an antiplatelet agent, is reported to induce the regression of atherosclerotic changes. However, its effects on carotid plaques are unknown. Hence, we quantitatively investigated the changes that occur within carotid plaques during cilostazol administration using three-dimensional (3D) ultrasonography (US) and non-gated magnetic resonance (MR) plaque imaging.MethodsWe prospectively examined 16 consecutive patients with carotid stenosis. 3D-US and T1-weighted MR plaque imaging were performed at baseline and 6 months after initiating cilostazol therapy (200 mg/day). We measured the volume and grayscale median (GSM) of the plaques from 3D-US data. We also calculated the contrast ratio (CR) of the carotid plaque against the adjacent muscle and areas of the intraplaque components: fibrous tissue, lipid, and hemorrhage components.ResultsThe plaque volume on US decreased significantly (median at baseline and 6 months, 0.23 and 0.21 cm3, respectively;p =0.03). In the group exhibiting a plaque volume reduction of more than 10%, GSM on US increased significantly (24.8 and 71.5, respectively;p =0.04) and CR on MRI decreased significantly (1.13 and 1.04, respectively;p =0.02). In this group, in addition, the percent area of the fibrous component on MRI increased significantly (68.6% and 79.4%, respectively;p =0.02), while those of the lipid and hemorrhagic components decreased (24.9% and 20.5%, respectively;p =0.12) (1.0% and 0.0%, respectively;p =0.04). There were no substantial changes in intraplaque characteristics in either US or MRI in the other group.Conclusions3D-US and MR plaque imaging can quantitatively detect changes in the size and composition of carotid plaques during cilostazol therapy.