Atherosclerotic plaque progression in carotid arteries: monitoring with high-spatial-resolution MR imaging--multicenter trial.
OBJECTIVE
To estimate the annualized rate of progression of vessel-wall volume in the carotid arteries in 160 patients by using magnetic resonance (MR) imaging and to establish the fraction of studies that have acceptable image quality.


METHODS
The study procedures and consent forms were reviewed and approved by each site's institutional review board. All U.S. study sites conducted all phases of this study in compliance with HIPAA requirements. Written consent was obtained from each participant. One hundred sixty patients with greater than 50% narrowing of the diameter of the carotid artery were recruited at six centers for prospective imaging of the carotid arteries at baseline and 1 year later by using high-spatial-resolution, 1.5-T MR imaging. Studies with unacceptable image quality were excluded. Quantitative changes in atheroma volume were measured on unenhanced T1-weighted images. A multiple linear regression analysis was used to correlate progression with several clinical factors, including statin therapy.


RESULTS
All 160 patients completed both baseline and follow-up studies. Of these studies, 67.5% were deemed to have image quality that was acceptable for quantitative analysis. The causes of rejection were motion (46%), deep location of the carotid artery (22%), low bifurcation of the carotid artery (13%), and "other" (19%). The mean annual change in vessel-wall volume was 2.31% +/- 10.88 (standard deviation) (P = .014). At 1-year follow-up, vessel-wall volumes in patients not receiving statin therapy had increased faster compared with those in patients receiving statin therapy: 7.87% +/- 13.58% vs 1.14% +/- 9.9%, respectively (P = .029).


CONCLUSIONS
Evaluation of results of a multicenter study indicates that quantitative evaluation of the progression of volume of extracranial carotid vessel walls is feasible with 1.5-T MR imaging despite limitations due to patient motion or habitus. In patients who had preexisting carotid disease, the rate of increase in vessel-wall volume was slower in patients receiving statin therapy.
Boussel
Loïc
L
Department of Radiology, University of California, San Francisco, San Francisco, Calif., USA. loic.boussel@gmail.com
Arora
Sandeep
S
Rapp
Joseph
J
Rutt
Brian
B
Huston
John
J
Parker
Dennis
D
Yuan
Chun
C
Bassiouny
Hisham
H
Saloner
David
D
D050197:Atherosclerosis / Q000473:pathology* / Q000517:prevention & control; D002340:Carotid Artery Diseases / Q000473:pathology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007089:Image Enhancement; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D014481:United States
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors