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.
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.


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%, chi2 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.
Murphy
Rachael E
RE
Department of Academic Radiology, University Hospital, Nottingham, UK. alan.moody@sw.ca
Moody
Alan R
AR
Morgan
Paul S
PS
Martel
Anne L
AL
Delay
G S
GS
Allder
Steve
S
MacSweeney
Shane T
ST
Tennant
William G
WG
Gladman
John
J
Lowe
John
J
Hunt
Beverley J
BJ
D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology; D002341:Carotid Artery Thrombosis / Q000175:diagnosis* / Q000453:epidemiology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015995:Prevalence; D012016:Reference Values