Usefulness of Plaque Magnetic Resonance Imaging in Identifying High-Risk Carotid Plaques Irrespective of the Degree of Stenosis.
10.7461/jcen.2017.19.4.291
- Author:
Jinseong LEE
1
;
Jinsang KIL
;
Dae Won KIM
;
Sung Don KANG
Author Information
1. Institute of Wonkwang Medical Science, Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Korea. kangsd@wku.ac.kr
- Publication Type:Original Article
- Keywords:
Atherosclerotic plaque;
Magnetic resonance imaging;
Hemorrhage;
Carotid stenosis
- MeSH:
Angiography;
Carotid Stenosis;
Constriction, Pathologic*;
Hemorrhage;
Humans;
Magnetic Resonance Imaging*;
Plaque, Atherosclerotic
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2017;19(4):291-300
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
