title: Carotid plaques in transient ischemic attack and stroke patients: one-year follow-up study by magnetic resonance imaging.
abstract: OBJECTIVE
  To investigate the natural course of carotid plaque progression in transient ischemic attack/stroke patients by using serial multisequence magnetic resonance imaging (MRI).
  
  
  METHODS
  Forty transient ischemic attack/stroke patients with ipsilateral <70% carotid stenosis underwent MRI of the plaque ipsilateral to the symptomatic side at baseline and after 1 year. The MRI protocol consisted of T1-weighted turbo field-echo, time-of-flight, T2-weighted turbo spin-echo (TSE), and pre- and postgadopentetate dimeglumine-enhanced T1-weighted TSE images. For each plaque, carotid lumen volume, wall volume, total vessel volume (=carotid lumen volume + wall volume), the presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and the presence of intraplaque hemorrhage (IPH) were assessed at both time points.
  
  
  RESULTS
  Over a 1-year period, mean carotid lumen volume decreased with 4.8% ± 2.0% (±standard error) (P = 0.013). Mean wall volume increased with 11.2% ± 2.2% (P < 0.001). Total vessel volume did not significantly change (P = 0.147). At baseline, there were 18 plaques with a LRNC, which also had a LRNC at 1-year follow-up. No plaque without a LRNC at baseline developed a LRNC during the follow-up period. All plaques with a LRNC had a thin and/or ruptured FC at both time points. Twelve patients had IPH both at baseline and at follow-up. In one patient, IPH disappeared, whereas in another patient, new IPH appeared at follow-up. The presence of IPH and a LRNC with a thin and/or ruptured FC were not significantly associated with plaque progression (P > 0.05).
  
  
  CONCLUSIONS
  In symptomatic patients with an ipsilateral carotid plaque causing <70% stenosis, we found evidence for inward plaque remodeling over a 1-year period. Overall, the presence/absence of IPH, a LRNC, and FC status did not change over 1 year.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kwee
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
authors.forename: Martin H
authors.initials: MH
authors.lastname: Prins
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van der Geest
authors.forename: Johannes W M
authors.initials: JW
authors.lastname: ter Berg
authors.forename: Cees L
authors.initials: CL
authors.lastname: Franke
authors.forename: Arthur G G C
authors.initials: AG
authors.lastname: Korten
authors.forename: Bé J
authors.initials: BJ
authors.lastname: Meems
authors.forename: Jos M A
authors.initials: JM
authors.lastname: van Engelshoven
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Marianne Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: D016893:Carotid Stenosis / Q000150:complications* / Q000473:pathology; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002546:Ischemic Attack, Transient / Q000209:etiology* / Q000473:pathology; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000473:pathology
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA