Association of Carotid Intraplaque Hemorrhage and Territorial Acute Infarction in Patients with Acute Neurological Symptoms Using Carotid Magnetization-Prepared Rapid Acquisition with Gradient-Echo.
10.3340/jkns.2015.57.2.94
- Author:
Jung Soo PARK
1
;
Hyo Sung KWAK
;
Jong Myong LEE
;
Eun Jeong KOH
;
Gyung Ho CHUNG
;
Seung Bae HWANG
Author Information
1. Department of Neurosurgery, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
- Publication Type:Original Article
- Keywords:
MRI;
Stroke;
Carotid artery;
Atherosclerosis
- MeSH:
Arteries;
Atherosclerosis;
Brain;
Carotid Arteries;
Carotid Stenosis;
Constriction, Pathologic;
Diffusion;
Hemorrhage*;
Humans;
Infarction*;
Magnetic Resonance Imaging;
Neurologic Manifestations;
Prevalence;
Stroke
- From:Journal of Korean Neurosurgical Society
2015;57(2):94-99
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of our study was to assess prevalence of carotid intraplaque hemorrhage (IPH) and associations between territorial acute infarction and IPH on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) in patients with acute neurologic symptoms. METHODS: 83 patients with suspected acute neurologic symptoms were evaluated with both brain diffusion weighted imaging (DWI) and carotid MPRAGE sequences. Carotid plaque with high signal intensity on MPRAGE of >200% that of adjacent muscle was categorized as IPH. We analyzed the prevalence of IPH and its correlation with territorial acute infarction. RESULTS: Of 166 arteries, 39 had a carotid artery plaque. Of these arteries, 26 had carotid artery stenosis less than 50%. In all carotid arteries, MR-depicted IPH was found in 7.2% (12/166). High-signal intensity on DWI was found in 17.5% (29/166). Combined lesion with ipsilateral high-signal intensity on DWI and IPH on carotid MPRAGE sequence was found in 6 lesions (6/166, 3.6%). Of patients with carotid artery plaque, MR-predicted IPH was found in 30.8% (12/39) and match lesions with high-signal intensity on DWI and MPRAGE was found in 15.4% (6/39). MR-predicted IPH was significantly higher prevalence in high-grade stenosis group (p=0.010). Relative risk between carotid MPRAGE-positive signal and ipsilateral high-signal intensity on DWI in arteries with carotid artery plaques was 6.8 (p=0.010). CONCLUSION: Carotid MPRAGE-positive signal in patients was associated with an increased risk of territorial acute infarction as detected objectively by brain DWI. The relative risk of stroke was increased in high-grade stenosis categories.
