Usefulness of Plaque Magnetic Resonance Imaging in Identifying High-Risk Carotid Plaques Irrespective of the Degree of Stenosis
| Autor: | Dae Won Kim, Jinseong Lee, Kang Ss, Jin-Sang Kil |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Atherosclerotic plaque
medicine.medical_specialty medicine.diagnostic_test business.industry Objective measurement Magnetic resonance imaging Hemorrhage 030204 cardiovascular system & hematology medicine.disease Stenosis degree 03 medical and health sciences Stenosis 0302 clinical medicine Angiography medicine Carotid stenosis Treatment strategy Plaque morphology Original Article Radiology Mild stenosis business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Cerebrovascular and Endovascular Neurosurgery |
| ISSN: | 2287-3139 2234-8565 |
| Popis: | Objective Measurement of the degree of stenosis is not enough to decide on the treatment strategy for patients with carotid stenosis. Plaque morphology examination is needed for such a decision-making. Thus, we evaluated the usefulness of plaque magnetic resonance imaging (MRI) to decide on the modality of treatment for patients with carotid atherosclerotic plaques. Materials and Methods Fifteen patients presenting with carotid stenosis between 2014 and 2016 were included. They underwent angiography for measurement of the degree of stenosis. Carotid plaques were visualized using MRI. Results There were six (40%) stable and nine (60%) unstable plaques. Seven symptomatic patients (77.7%) had unstable lesions and two symptomatic patients (33.3%) had stable lesions (p = 0.096). There were six (40%) intraplaque hemorrhage (IPH) cases. There were six symptomatic patients (100%) in the IPH group and three symptomatic patients (33.3%) in the non-IPH group (p = 0.013). The mean stenosis degree was 58.9% in the IPH group and 70.4% in the non-IPH group (p = 0.094). Symptoms occurred irrespective of the degree of the stenosis in the IPH groups. In the IPH group, the recurrent ischemic cerebrovascular event rate was 33.3%. Particularly, the recurrent ischemic cerebrovascular event rate was 66.7% in the IPH group with mild stenosis treated with medications. Conclusion IPH in plaque MRI is significantly associated with ischemic symptoms and has a high risk for subsequent ischemic cerebrovascular events irrespective of the degree of stenosis. Plaque MRI is a useful tool in predicting symptomatic risks for carotid stenosis irrespective of the degree of such stenosis. |
| Databáze: | OpenAIRE |
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