MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence

作者：Kwee Robert M^*; van Oostenbrugge Robert J; Mess Werner H; Prins Martin H; van der Geest Rob J; ter Berg Johannes W M; Franke Cees L; Korten Arthur G G C; Meems Be J; van Engelshoven Jos M A; Wildberger Joachim E; Kooi M Eline

来源：Journal of Magnetic Resonance Imaging, 2013, 37(5): 1189-1194.

DOI：10.1002/jmri.23918

• carotid atherosclerosis
• TIA
• stroke
• plaque
• MRI

Purpose: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. Materials and Methods: One hundred twenty-six TIA/stroke patients with ipsilateral 3069% carotid stenosis underwent multisequence carotid plaque MRI. The presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and intraplaque hemorrhage (IPH) were assessed. Patients were followed to determine the recurrence of ipsilateral TIA and/or stroke within 1 year after inclusion. Results: Thirteen patients suffered from recurrent ipsilateral clinical ischemic events (10 TIAs and 3 strokes). Carotid stenosis grade was not associated with recurrent events (hazard ratio [HR] for 5069% versus 3049% stenosis = 1.198; 95% confidence interval [CI], 0.383 to 3.749; P = 0.756). The presence of an LRNC (HR = 3.2001; 95% CI, 1.078 to 9.504; P = 0.036), a thin and/or ruptured FC (HR = 5.756; 95% CI, 1.913 to 17.324; P = 0.002), and IPH (HR = 3.542; 95% CI, 1.058 to 11.856; P = 0.040) were associated with recurrence. Conclusion: The presence of MRI-depicted LRNC, a thin and/or ruptured FC, and IPH are associated with the recurrence of clinical cerebrovascular ischemic events in TIA and stroke patients with carotid atherosclerosis. J. Magn. Reson. Imaging 2013;37:11891194.

• 出版日期2013-5