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Updated: May 8, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Carotid plaque MRI and stroke risk: a systematic review and meta-analysis

Ajay Gupta1, Hediyeh Baradaran, Andrew D Schweitzer

  • 1From the Departments of Radiology (A.G., H.B., A.D.S., P.C.S.), Neurology (H.K.), and Public Health (A.P., A.D., A.I.M., P.C.S.) and Samuel J. Wood Library & C.V. Starr Biomedical Information Center (D.D.), Weill Cornell Medical College, New York, NY.

Stroke
|August 31, 2013
PubMed
Abstract

Insights

Magnetic Resonance Imaging (MRI) of carotid plaque can predict stroke risk. Key features like intraplaque hemorrhage and lipid-rich necrotic core significantly increase the likelihood of ischemic events.

Area of Science:

  • Neuroimaging
  • Cardiovascular Research
  • Stroke Prevention

Background:

  • Carotid atherosclerosis is a leading cause of stroke.
  • MRI offers detailed characterization of carotid plaque composition.
  • Plaque features may predict future ischemic events.

Purpose of the Study:

  • To systematically review and meta-analyze MRI-determined carotid plaque features.
  • To assess the association of intraplaque hemorrhage, lipid-rich necrotic core, and fibrous cap status with ischemic events.

Main Methods:

  • Comprehensive literature search for cohort studies.
  • Inclusion criteria: MRI plaque features, follow-up ≥1 month, ipsilateral stroke/TIA outcome.
  • Meta-analysis using random-effects model with heterogeneity and bias assessment.

Main Results:

  • 9 studies with 779 subjects were included.
  • Hazard ratios for stroke/TIA: Intraplaque hemorrhage (4.59), Lipid-rich necrotic core (3.00), Thinning/rupture of fibrous cap (5.93).
  • No significant heterogeneity or publication bias detected.

Conclusions:

  • MRI-identified carotid plaque hemorrhage, necrotic core, and cap defects predict stroke/TIA risk.
  • Carotid plaque MRI provides stroke risk information beyond luminal stenosis.
Keywords:
MRIcarotid arteriescarotid artery plaque ▪ ischemic attack, transientriskstroke

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