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J Cerebrovasc Endovasc Neurosurg. 2017 Dec;19(4):291-300. doi: 10.7461/jcen.2017.19.4.291. Epub 2017 Dec 31.

Usefulness of Plaque Magnetic Resonance Imaging in Identifying High-Risk Carotid Plaques Irrespective of the Degree of Stenosis.

Author information

1
Institute of Wonkwang Medical Science, Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Korea.

Abstract

Objective:

Measurement of the degree of stenosis is not enough to decide on the treatment strategy for patients with carotid stenosis. Plaque morphology examination is needed for such a decision-making. Thus, we evaluated the usefulness of plaque magnetic resonance imaging (MRI) to decide on the modality of treatment for patients with carotid atherosclerotic plaques.

Materials and Methods:

Fifteen patients presenting with carotid stenosis between 2014 and 2016 were included. They underwent angiography for measurement of the degree of stenosis. Carotid plaques were visualized using MRI.

Results:

There were six (40%) stable and nine (60%) unstable plaques. Seven symptomatic patients (77.7%) had unstable lesions and two symptomatic patients (33.3%) had stable lesions (p = 0.096). There were six (40%) intraplaque hemorrhage (IPH) cases. There were six symptomatic patients (100%) in the IPH group and three symptomatic patients (33.3%) in the non-IPH group (p = 0.013). The mean stenosis degree was 58.9% in the IPH group and 70.4% in the non-IPH group (p = 0.094). Symptoms occurred irrespective of the degree of the stenosis in the IPH groups. In the IPH group, the recurrent ischemic cerebrovascular event rate was 33.3%. Particularly, the recurrent ischemic cerebrovascular event rate was 66.7% in the IPH group with mild stenosis treated with medications.

Conclusion:

IPH in plaque MRI is significantly associated with ischemic symptoms and has a high risk for subsequent ischemic cerebrovascular events irrespective of the degree of stenosis. Plaque MRI is a useful tool in predicting symptomatic risks for carotid stenosis irrespective of the degree of such stenosis.

KEYWORDS:

Atherosclerotic plaque; Carotid stenosis; Hemorrhage; Magnetic resonance imaging

Conflict of interest statement

Disclosure: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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