Major carotid plaque surface irregularities correlate with neurologic symptoms
| Autor: | Aaron Troyer, Pauline M. Velez, David Saloner, Xian Mang Pan, Joseph H. Rapp |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty Lumen (anatomy) Central nervous system disease medicine.artery medicine Humans Carotid Stenosis cardiovascular diseases Stroke Aged medicine.diagnostic_test Vascular disease business.industry Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Cerebral Angiography Stenosis Carotid Arteries Ischemic Attack Transient Surgery Female Radiology Internal carotid artery Cardiology and Cardiovascular Medicine business Cerebral angiography |
| Zdroj: | Journal of vascular surgery. 35(4) |
| ISSN: | 0741-5214 |
| Popis: | Purpose: Many studies have linked carotid plaque surface irregularities with stroke risk, but this relationship has been obscured by the limited ability of available imaging modalities to resolve plaque surface morphology. To address this issue, we performed a prospective study correlating the presenting neurologic symptoms of patients with high-resolution magnetic resonance imaging (MRI; 200 μm) studies of ipsilateral plaque surface invaginations and ledges, lumen shape, and the location of the plaque bulk creating the stenosis. Methods: One hundred patients, 17 women and 83 men, 45 to 81 years old (mean, 68 years) underwent surgery. Forty-five patients had a transient ischemic attack (TIA) or stroke as the indication for surgery, and 55 patients had no symptoms. Angiograms were obtained in 50 patients. Carotid plaques were removed “en bloc” and placed in gadolinium doped saline for imaging in a Siemens Symphony, 1.5T scanner with a custom-built transmit-receive radiofrequency coil. The resulting slice thickness was 200 μm, with 200 μm by 200 μm in plane resolution. The MRI data and angiograms were reviewed by using National Institutes of Health Image software and read by consensus. A surface irregularity was categorized as a ledge or ulcer and measured by using electronic calipers. Luminal shape was determined at the point of maximal stenosis with a “slice” set at 90° to the lumen axis. The location of the maximal stenosis was recorded. In the internal carotid artery, plaque bulk was designated to be on the flow divider wall or non-flow divider wall. Results: The mean maximal stenosis was 81.5% ± 12.0%. Surface contour irregularities were found in 80 plaques. Thirty-five plaques were graded as having major surface contour irregularities, and 45 plaques were graded as having minor irregularities. There was a significant correlation between major surface irregularity and TIA or stroke (P |
| Databáze: | OpenAIRE |
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