Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study
| Autor: | Jeroen Hendrikse, A.F.W. van der Steen, Paul J. Nederkoorn, Jolanda J. Wentzel, Peter J. Koudstaal, ME Marianne Eline Kooi, A. van der Lugt, Kristine Dilba, D.H.K. van Dam-Nolen, A.C. van Dijk, Mohamed Kassem |
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| Přispěvatelé: | Beeldvorming, RS: Carim - B06 Imaging, MUMC+: DA BV Klinisch Fysicus (9), Radiology & Nuclear Medicine, Neurology, Cardiology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders |
| Rok vydání: | 2020 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty Necrotic core Carotid arteries Gastroenterology 030218 nuclear medicine & medical imaging Necrosis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Extracranial Vascular Ulcer Aged business.industry Plaque composition Fibrous cap Plaque rupture Middle Aged medicine.disease Lipids Magnetic Resonance Imaging Mr imaging Plaque Atherosclerotic Stenosis medicine.anatomical_structure Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | AJNR Am J Neuroradiol American Journal of Neuroradiology, 42(1), 144-151. American Society of Neuroradiology |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a6868 |
| Popis: | BACKGROUND AND PURPOSE: Plaque ulceration is a marker of previous plaque rupture. We studied the association between atherosclerotic plaque composition at baseline and plaque ulceration at baseline and follow-up. MATERIALS AND METHODS: We included symptomatic patients with a carotid stenosis of ,70% who underwent MDCTA and MR imaging at baseline (n=180). MDCTA was repeated at 2 years (n=73). We assessed the presence of ulceration using MDCTA. Baseline MR imaging was used to assess the vessel wall volume and the presence and volume of plaque components (intraplaque hemorrhage, lipid-rich necrotic core, and calcifications) and the fibrous cap status. Associations at baseline were evaluated with binary logistic regression and reported with an OR and its 95% CI. Simple statistical testing was performed in the follow-up analysis. RESULTS: At baseline, the prevalence of plaque ulceration was 27% (49/180). Increased wall volume (OR = 12.1; 95% CI, 3.5-42.0), higher relative lipid-rich necrotic core (OR= 1.7; 95% CI, 1.3-2.2), higher relative intraplaque hemorrhage volume (OR= 1.7; 95% CI, 1.3-2.2), and a thin-or-ruptured fibrous cap (OR = 3.4; 95% CI, 1.7-6.7) were associated with the presence of ulcerations at baseline. In 8% (6/73) of the patients, a new ulcer developed. Plaques with a new ulceration at follow-up had at baseline a larger wall volume (1.04 cm3 [IQR, 0.97-1.16 cm3] versus 0.86 cm3 [IQR, 0.73-1.00 cm3]; P=.029), a larger relative lipid-rich necrotic core volume (23% [IQR, 13-31%] versus 2% [IQR, 0-14%]; P=.002), and a larger relative intraplaque hemorrhage volume (14% [IQR, 8-24%] versus 0% [IQR, 0-5%]; PCONCLUSIONS: Large atherosclerotic plaques and plaques with intraplaque hemorrhage and lipid-rich necrotic cores were associated with plaque ulcerations at baseline and follow-up. |
| Databáze: | OpenAIRE |
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