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Intraplaque Hemorrhage: A Comparative Study of Vulnerable Plaque With Magnetic Resonance Imaging and Doppler
Mine Sezgin1, Sevil Yusifli1, Mehmet Barburoğlu2
1Department of Neurology, İstanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Insights
Intraplaque hemorrhage (IPH) is moderately associated with heterogeneous and irregular carotid artery plaques. These features aid in identifying patients at high risk for ischemic stroke.
Area of Science:
- Vascular Medicine
- Radiology
- Neurology
Background:
- Carotid artery disease (CAD) poses a significant risk for ischemic stroke.
- Identifying vulnerable atherosclerotic plaques is crucial for risk stratification.
Purpose of the Study:
- To compare plaque features, including intraplaque hemorrhage (IPH), using carotid Doppler ultrasonography (USG) and MRA.
- To assess the association of IPH with plaque characteristics in symptomatic and asymptomatic CAD.
Main Methods:
- Carotid Doppler USG and MRA (3D TFE sequence) were used to evaluate plaque features and IPH.
- Internal carotid artery (ICA) systolic flow velocity and surface characteristics were analyzed in 52 vessels.
Main Results:
- Heterogeneous plaques were more common in symptomatic ICAs (65%) than asymptomatic (39%).
- IPH showed moderate correlation with heterogeneous plaque (Cramer V=0.36) and irregular surface (Cramer V=0.45).
- A strong association was found between IPH and >=50% stenosis (NASCET criteria, Cramer V=0.53).
Conclusions:
- Heterogeneous plaque and surface irregularity are moderately associated with IPH.
- These features can aid in screening, follow-up, and management of patients at high risk for ischemic stroke.
- Identifying IPH and associated plaque features helps stratify cerebrovascular disease risk.
Purpose:
We compared various plaque features including intraplaque hemorrhage (IPH) by carotid Doppler ultrasonography (USG) and MRA in individuals with symptomatic and asymptomatic carotid artery disease (CAD).
Methods:
Symptomatic and asymptomatic CAD cases were included in the study. Surface features and constituents of the atherosclerotic plaque were examined, and internal carotid artery (ICA) systolic flow velocity was measured. Intra-plaque hemorrhage was assessed with a 3D TFE sequence.
Results:
Each carotid artery was inspected separately, and evaluations were made on 52 vessels for Doppler and 3D TFE analysis. In Doppler USG, heterogeneous plaques were found in 65% of symptomatic ICAs and 39% of asymptomatic ICAs (p = 0.08). There was a moderate correlation between the presence of IPH and heterogeneous plaque (Cramer V = 0.36, p = 0.01), moderate correlation with the presence of irregular plaque surface (Cramer V = 0.45, p = 0.003), mild correlation with the presence of flow acceleration (Cramer's V = 0.26 p = 0.064); strong association of 50% or more stenosis according to NASCET criteria (Cramer's V = 0.53 p = 0.00) were found.
Conclusions:
Heterogeneous plaque and surface irregularity that show moderate association with IPH can be used as a helpful tool in the screening, follow-up, and management of patients at high risk of ischemic stroke and determining risk groups for cerebrovascular diseases.
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