Published online before print June 9, 2003, doi: 10.1161/01.CIR.0000074204.92443.37
(Circulation. 2003;107:3053.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Prevalence of Complicated Carotid Atheroma as Detected by Magnetic Resonance Direct Thrombus Imaging in Patients With Suspected Carotid Artery Stenosis and Previous Acute Cerebral Ischemia
From the Departments of Academic Radiology (R.E.M., A.R.M., P.S.M., A.L.M., G.S.D., S.A.); Vascular Surgery (S.T.M., W.G.T.); and Neuropathology (J.L.) and the Ageing and Disability Research Unit (J.G.), University Hospital, Nottingham, and Department of Haematology (B.J.H.), Guy’s and St Thomas’s Trust, London, UK.
Correspondence to Alan Moody, Radiologist in Chief, Department of Medical Imaging (Office AG57), Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5. E-mail alan.moody{at}sw.ca
Background— It is recognized that complicated plaque largely accounts for the morbidity and mortality from atherosclerosis. Ideally, investigation of symptomatic and asymptomatic patients would identify atheromatous plaques independently of stenosis. We have previously shown that a magnetic resonance direct thrombus imaging (MRDTI) technique demonstrates complicated atheroma as high signal within the carotid arterial wall. We used this technique to examine the prevalence of complicated carotid plaque in vivo in the ipsilateral arteries of recently symptomatic patients with suspected carotid artery stenosis and to compare this with their contralateral arteries and with those of healthy age- and sex-matched controls.
Methods and Results— The carotid arteries of 120 patients with suspected severe carotid artery stenosis and previous acute cerebral ischemia were imaged using MRDTI, as were 28 control arteries. High signal was not seen in any control artery. However, there was a 60% prevalence of high signal, suggestive of complicated plaque in the patients’ ipsilateral arteries. The prevalence of high signal was significantly greater in the patients’ ipsilateral vessels compared with the contralateral, asymptomatic side (60% versus 36%, 
2 P<0.001), particularly for vessels of only moderate stenosis.
Conclusions— MRDTI high signal suggestive of complicated plaque is prevalent in the ipsilateral carotid arteries of patients with carotid stenosis and recent cerebral ischemic events. MRDTI has a potential role in identifying "at risk" plaque, studying atherogenesis and the effects of plaque-modifying strategies.
Key Words: plaque • carotid arteries • magnetic resonance imaging • cerebral ischemia
This article has been cited by other articles:
 |
|
 |
|
  R.M. Kwee, F.H.B.M. Schreuder, W.H. Mess, R.J. van Oostenbrugge, V.H.J.M. Triebels, L.H. van den Akker, S. Heeneman, P.A.M. Hofman, J.M.A. van Engelshoven, J.E. Wildberger, et al. Development of Carotid Intraplaque Hemorrhage Demonstrated by Serial Magnetic Resonance Imaging Circulation, October 20, 2009; 120(16): 1637 - 1639. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ota, W. Yu, H. R. Underhill, M. Oikawa, L. Dong, X. Zhao, N. L. Polissar, B. Neradilek, T. Gao, Z. Zhang, et al. Hemorrhage and Large Lipid-Rich Necrotic Cores Are Independently Associated With Thin or Ruptured Fibrous Caps: An In vivo 3T MRI Study Arterioscler Thromb Vasc Biol, October 1, 2009; 29(10): 1696 - 1701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Singh, A. R. Moody, D. J. Gladstone, G. Leung, R. Ravikumar, J. Zhan, and R. Maggisano Moderate Carotid Artery Stenosis: MR Imaging-depicted Intraplaque Hemorrhage Predicts Risk of Cerebrovascular Ischemic Events in Asymptomatic Men Radiology, August 1, 2009; 252(2): 502 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kawasaki, S. Koga, N. Koga, T. Noguchi, H. Tanaka, H. Koga, T. Serikawa, Y. Orita, S. Ikeda, T. Mito, et al. Characterization of Hyperintense Plaque With Noncontrast T1-Weighted Cardiac Magnetic Resonance Coronary Plaque Imaging: Comparison With Multislice Computed Tomography and Intravascular Ultrasound J. Am. Coll. Cardiol. Img., June 1, 2009; 2(6): 720 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bitar, A. R. Moody, G. Leung, S. Symons, S. Crisp, J. Butany, C. Rowsell, A. Kiss, A. Nelson, and R. Maggisano In Vivo 3D High-Spatial-Resolution MR Imaging of Intraplaque Hemorrhage Radiology, October 1, 2008; 249(1): 259 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Altaf, P. S. Morgan, A. Moody, S. T. MacSweeney, J. R. Gladman, and D. P. Auer Brain White Matter Hyperintensities Are Associated with Carotid Intraplaque Hemorrhage Radiology, July 1, 2008; 248(1): 202 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yoshida, O. Narumi, M. Chin, K. Inoue, T. Tabuchi, K. Oda, M. Nagayama, N. Egawa, M. Hojo, Y. Goto, et al. Characterization of Carotid Atherosclerosis and Detection of Soft Plaque with Use of Black-Blood MR Imaging AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 868 - 874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Yuan Carotid atherosclerosis and magnetic resonance imaging. J. Am. Coll. Cardiol. Img., January 1, 2008; 1(1): 58 - 60. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Bitar, A. R. Moody, G. Leung, A. Kiss, D. Gladstone, D. J. Sahlas, and R. Maggisano In vivo identification of complicated upper thoracic aorta and arch vessel plaque by MR direct thrombus imaging in patients investigated for cerebrovascular disease. Am. J. Roentgenol., July 1, 2006; 187(1): 228 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Daniels, J. R. Gladman, N. Altaf, and A. R. Moody Magnetic Resonance Direct Thrombus Imaging in Moderate Carotid Artery Stenosis Stroke, March 1, 2006; 37(3): 767 - 768. [Full Text] [PDF]
|
|
|
|
|
|
N. Nighoghossian, L. Derex, and P. Douek The Vulnerable Carotid Artery Plaque: Current Imaging Methods and New Perspectives Stroke, December 1, 2005; 36(12): 2764 - 2772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Raggi, A. Taylor, Z. Fayad, D. O'Leary, S. Nissen, D. Rader, and L. J. Shaw Atherosclerotic Plaque Imaging: Contemporary Role in Preventive Cardiology Arch Intern Med, November 14, 2005; 165(20): 2345 - 2353. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Wasserman, R. J. Wityk, H. H. Trout III, and R. Virmani Low-Grade Carotid Stenosis: Looking Beyond the Lumen With MRI Stroke, November 1, 2005; 36(11): 2504 - 2513. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuster, Z. A. Fayad, P. R. Moreno, M. Poon, R. Corti, and J. J. Badimon Atherothrombosis and High-Risk Plaque: Part II: Approaches by Noninvasive Computed Tomographic/Magnetic Resonance Imaging J. Am. Coll. Cardiol., October 4, 2005; 46(7): 1209 - 1218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Viereck, F. L. Ruberg, Y. Qiao, A. S. Perez, K. Detwiller, M. Johnstone, and J. A. Hamilton MRI of Atherothrombosis Associated With Plaque Rupture Arterioscler Thromb Vasc Biol, January 1, 2005; 25(1): 240 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kampschulte, M.S. Ferguson, W.S. Kerwin, N. L. Polissar, B. Chu, T. Saam, T.S. Hatsukami, and C. Yuan Differentiation of Intraplaque Versus Juxtaluminal Hemorrhage/Thrombus in Advanced Human Carotid Atherosclerotic Lesions by In Vivo Magnetic Resonance Imaging Circulation, November 16, 2004; 110(20): 3239 - 3244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Chu, A. Kampschulte, M. S. Ferguson, W. S. Kerwin, V. L. Yarnykh, K. D. O'Brien, N. L. Polissar, T. S. Hatsukami, and C. Yuan Hemorrhage in the Atherosclerotic Carotid Plaque: A High-Resolution MRI Study Stroke, May 1, 2004; 35(5): 1079 - 1084. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Warach and J.-C. Baron Neuroimaging Stroke, February 1, 2004; 35(2): 351 - 353. [Full Text] [PDF]
|
|