Comparison of symptomatic and asymptomatic atherosclerotic carotid plaque features with in vivo MR imaging.

Abstract

PURPOSE:

To retrospectively determine if in vivo magnetic resonance (MR) imaging can simultaneously depict differences between symptomatic and asymptomatic carotid atherosclerotic plaque.

MATERIALS AND METHODS:

Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Twenty-three patients (21 men, two women; mean age, 66.1 years +/- 11.0 [standard deviation]) with unilateral symptomatic carotid disease underwent 1.5-T time-of-flight MR angiography and 1.5-T T1-, intermediate-, and T2-weighted MR imaging. Both carotid arteries were reviewed. One observer recorded quantitative and morphologic information, which included measurement of the area of the lumen, artery wall, and main plaque components; fibrous cap status (thick, thin, or ruptured); American Heart Association (AHA) lesion type (types I-VIII); and location (juxtaluminal vs intraplaque) and type of hemorrhage. Plaques associated with neurologic symptoms and asymptomatic plaques were compared with Wilcoxon signed rank and McNemar tests.

RESULTS:

Compared with asymptomatic plaques, symptomatic plaques had a higher incidence of fibrous cap rupture (P = .007), juxtaluminal hemorrhage or thrombus (P = .039), type I hemorrhage (P = .021), and complicated AHA type VI lesions (P = .004) and a lower incidence of uncomplicated AHA type IV and V lesions (P = .005). Symptomatic plaques also had larger hemorrhage (P = .003) and loose matrix (P = .014) areas and a smaller lumen area (P = .008). No significant differences between symptomatic and asymptomatic plaques were found for quantitative measurements of the lipid-rich necrotic core, calcification, and the vessel wall or for the occurrence of intraplaque hemorrhage or type II hemorrhage.

CONCLUSION:

This study revealed significant differences between symptomatic and asymptomatic plaques in the same patient.

• Authors: Tobias Saam, Jianming Cai, Lin Ma, You-Quan Cai, Marina S Ferguson, Nayak L Polissar, Thomas S Hatsukami, Chun Yuan
• Journal: Radiology (Radiology) Vol. 240 Issue 2 Pg. 464-72 (Aug 2006) ISSN: 0033-8419 [Print] United States
• PMID: 16864672 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: RSNA, 2006

Topics

• Aged
• Aged, 80 and over
• Arteriosclerosis (pathology)
• Carotid Artery Diseases (pathology)
• Female
• Humans
• Magnetic Resonance Angiography (methods)
• Male
• Middle Aged
• Statistics, Nonparametric