MR carotid plaque imaging and contrast-enhanced MR angiography identifies lesions associated with recent ipsilateral thromboembolic symptoms: an in vivo study at 3T.
MR carotid plaque imaging and contrast-enhanced MR angiography identifies lesions associated with recent ipsilateral thromboembolic symptoms: an in vivo study at 3T.
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DOI：
10.3174/ajnr.a2213
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Yuan C
中科院分区：
文献类型：
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作者：
Demarco JK;Ota H;Underhill HR;Zhu DC;Reeves MJ;Potchen MJ;Majid A;Collar A;Talsma JA;Potru S;Oikawa M;Dong L;Zhao X;Yarnykh VL;Yuan C
最近的研究表明，斑块组成的重要性，以确定患者的中风风险。本研究旨在识别轻度/中度与重度狭窄患者中与近期颈动脉血栓栓塞症状相关的3 T颈动脉MR成像和CE-MRA上的特定斑块特征。97例超声或CT血管造影显示狭窄50%-99%的连续患者（有症状，13例;无症状，84例）接受了颈动脉斑块成像结合3 T MRA。选择有症状的颈动脉或最狭窄的无症状颈动脉作为待分析的索引血管。根据MRA上轻度/中度（30%-70%）与重度（70%-99%）狭窄患者的症状状态比较斑块特征。90例（92.8%）患者的图像质量足以进行判读。在50例轻度/中度狭窄患者中，以下斑块特征与症状之间存在显著相关性：薄/破裂纤维帽（100% vs 36%，P = 0.006）和富脂坏死核心（100% vs 39%，P = 0.022），与出血边缘相关（86% vs 33%，P = 0.055）。在40例重度狭窄患者中，只有血管造影显示溃疡（86%对36%，P = 0.039）与症状相关。在3 T MR成像上发现的几个斑块成分与最近的同侧颈动脉血栓栓塞症状相关。这些初步结果还表明，斑块特征和症状史之间的关联可能因狭窄程度而异。如果在大型研究中得到证实，颈动脉MR成像可以区分稳定和不稳定的病变，特别是在目前尚不清楚手术干预作用的轻度/中度狭窄患者中。
Recent research has suggested the importance of plaque composition to identify patients at risk for stroke. This study aims to identify specific plaque features on 3T carotid MR imaging and CE-MRA associated with recent carotid thromboembolic symptoms in patients with mild/moderate versus severe stenosis. Ninety-seven consecutive patients (symptomatic, 13; asymptomatic, 84) with 50%–99% stenosis by sonography or CT angiography underwent carotid plaque imaging combined with MRA at 3T. The symptomatic carotid artery or the most stenotic asymptomatic carotid artery was chosen as the index vessel to be analyzed. Plaque features were compared by symptomatic status in patients with mild/moderate (30%–70%) versus severe (70%–99%) stenosis on MRA. Ninety (92.8%) patients had sufficient image quality for interpretation. In 50 patients with mild/moderate stenosis, there were significant associations between the presence of the following plaque characteristics and symptoms: thin/ruptured fibrous cap (100% versus 36%, P = .006) and lipid-rich necrotic core (100% versus 39%, P = .022), with marginal association with hemorrhage (86% versus 33%, P = .055). In 40 patients with severe stenosis, only the angiographic presence of ulceration (86% versus 36%, P = .039) was associated with symptoms. Several plaque components identified on 3T MR imaging are correlated with recent ipsilateral carotid thromboembolic symptoms. These preliminary results also suggest that associations between plaque characteristics and symptom history may vary by degree of stenosis. If confirmed in larger studies, carotid MR imaging may distinguish stable from unstable lesions, particularly in individuals with mild/moderate stenosis in whom the role of surgical intervention is currently unclear.