Distribution of high-resolution magnetic resonance imaging -based carotid Plaque-RADS subtypes among patients with
Wanchen Liu1,2, Zhiji Zheng3, Wenbin Zhang4
1Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Insights
High-risk carotid plaques identified by high-resolution MRI (HRMRI) Plaque-RADS, especially enhanced plaques, are linked to cerebral infarction. This classification system aids in identifying vulnerable plaques.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Imaging
Background:
- The Carotid Plaque Reporting and Data System (Plaque-RADS) is a quantitative grading system for carotid plaque stability.
- High-resolution magnetic resonance imaging (HRMRI) provides detailed visualization of plaque characteristics.
Purpose of the Study:
- To apply HRMRI-based Plaque-RADS classification to characterize carotid plaques in patients with acute cerebral infarction (ACI).
- To assess the association between different Plaque-RADS classifications and the presence of cerebral infarction.
Main Methods:
- Retrospective collection of HRMRI images from 98 patients with ACI.
- Carotid plaques categorized into Plaque-RADS 1-4 subtypes (1-2 low-risk, 3-4 high-risk).
- High-risk plaques further classified as enhanced or non-enhanced after contrast injection; analyzed using mixed-effects logistic regression.
Main Results:
- Plaque-RADS 3 and 4 (high-risk) were significantly associated with the infarction side (OR=3.71).
- Enhanced high-risk plaques were also significantly associated with the infarction side (OR=3.05).
- Distribution of plaque types differed significantly between infarction and contralateral sides.
Conclusions:
- HRMRI-based Plaque-RADS identifies high-risk and enhanced high-risk plaques associated with cerebral infarction.
- Plaque enhancement provides supplementary information to the Plaque-RADS classification.
- HRMRI-based Plaque-RADS effectively identifies vulnerable carotid plaques in patients with ACI.
Background:
The Carotid Plaque Reporting and Data System (Plaque-RADS) is a new quantitative grading system for plaque stability. Herein, high-resolution magnetic resonance imaging (HRMRI)-based Plaque-RADS(HRMRI-Plaque-RADS) classification was performed to characterize the different classifications in patients with cerebral infarction.
Methods:
HRMRI images from patients with acute cerebral infarction (ACI) of the anterior cerebral circulation were collected retrospectively, and carotid plaques were categorized into the Plaque-RADS 1-4 subtypes. Plaque-RADS 1 and 2 were considered low-risk, and Plaque-RADS 3 and 4 as high-risk. After contrast agent injection, high-risk plaques were further classified as enhanced or non-enhanced. A mixed-effects logistic regression model was applied to identify relationships between plaque types and infarction.
Results:
This study included 98 patients (age 65.6 ± 9.6 years; 88.8% male; 196 carotid arteries). The distribution of Plaque-RADS 1-4 plaques on the infarction side was: 7 (7.1%), 13 (13.2%), 49 (50.0%), and 29 (29.6%), respectively. Among the high-risk plaques, 50 (51%) were enhanced high-risk. The distribution of Plaque-RADS 1-4 plaques on the contralateral side was: 26 (26.5%), 21 (21.4%), 43 (43.9%), and 8 (8.2%), respectively, with 28 (28.6%) high-risk plaques classified as enhanced high-risk. The high-risk and enhanced high-risk plaque types were significantly associated with the infarction side (odds ratio [OR] = 3.71, 95% confidence interval [CI], 1.96-7.05; P < 0.001, after adjustment; OR = 3.05, 95%CI, 1.78-5.23; P < 0.001).
Conclusion:
In ACI, HRMRI-Plaque-RADS based high-risk and enhanced high-risk plaques were associated with the infarction side. Plaque enhancement offered a supplement to the Plaque-RADS, and HRMRI based Plaque-RADS classification may effectively identify vulnerable plaques.
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