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Carotid plaque composition and cerebral infarction: MR imaging study
Mohamed Ouhlous1, H Zwenneke Flach, Thomas T de Weert
1Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.
AJNR. American Journal of Neuroradiology
|May 14, 2005
Summary
Atherosclerotic plaque composition, particularly lipid cores, is linked to ischemic cerebral lesions in patients with carotid artery stenosis. MR imaging can assess plaque characteristics and their association with stroke risk.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Medicine
Background:
- Carotid artery stenosis severity is a known stroke risk factor.
- Atherosclerotic plaque composition also influences cerebral symptom development.
- Understanding plaque characteristics is crucial for assessing stroke risk.
Purpose of the Study:
- To investigate the relationship between carotid artery bifurcation plaque composition and ipsilateral ischemic cerebral lesions.
- To determine if MR imaging can identify plaque features associated with stroke.
Main Methods:
- 41 patients with >70% symptomatic carotid artery stenosis were studied.
- Black-blood, fast spin-echo MR imaging of carotid arteries and t-FLAIR MR imaging of the brain were performed.
- Lipid cores were identified by signal intensity changes on MR imaging; infarcts were assessed on brain MRIs.
Main Results:
- Lipid cores were present in 25 patients (61%).
- Ipsilateral infarcts occurred in 54% of patients, frequently in the centrum semiovale.
- Patients with lipid cores had a significantly higher incidence of ipsilateral infarcts (68% vs. 31%, P = .03).
Conclusions:
- Ischemic cerebral lesions are prevalent in symptomatic carotid artery disease.
- MR imaging assessment of carotid plaque composition is related to the presence and extent of ischemic cerebral lesions.
- Plaque lipid content is a significant imaging marker for stroke risk in carotid stenosis.