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J Magn Reson Imaging. 2013 May;37(5):1189-94. doi: 10.1002/jmri.23918. Epub 2012 Nov 16.

MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence.

Author information

1
Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands. rmkwee@gmail.com

Abstract

PURPOSE:

To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients.

MATERIALS AND METHODS:

One hundred twenty-six TIA/stroke patients with ipsilateral 30-69% carotid stenosis underwent multisequence carotid plaque MRI. The presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and intraplaque hemorrhage (IPH) were assessed. Patients were followed to determine the recurrence of ipsilateral TIA and/or stroke within 1 year after inclusion.

RESULTS:

Thirteen patients suffered from recurrent ipsilateral clinical ischemic events (10 TIAs and 3 strokes). Carotid stenosis grade was not associated with recurrent events (hazard ratio [HR] for 50-69% versus 30-49% stenosis = 1.198; 95% confidence interval [CI], 0.383 to 3.749; P = 0.756). The presence of an LRNC (HR = 3.2001; 95% CI, 1.078 to 9.504; P = 0.036), a thin and/or ruptured FC (HR = 5.756; 95% CI, 1.913 to 17.324; P = 0.002), and IPH (HR = 3.542; 95% CI, 1.058 to 11.856; P = 0.040) were associated with recurrence.

CONCLUSION:

The presence of MRI-depicted LRNC, a thin and/or ruptured FC, and IPH are associated with the recurrence of clinical cerebrovascular ischemic events in TIA and stroke patients with carotid atherosclerosis.

PMID:
23166040
DOI:
10.1002/jmri.23918
[Indexed for MEDLINE]

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