title: Association between carotid plaque characteristics and cerebral white matter lesions: one-year follow-up study by MRI.
abstract: OBJECTIVE
  To prospectively assess the relation between carotid plaque characteristics and the development of new cerebral white matter lesions (WMLs) at MRI.
  
  
  METHODS
  Fifty TIA/stroke patients with ipsilateral 30-69% carotid stenosis underwent MRI of the plaque at baseline. Total plaque volume and markers of vulnerability to thromboembolism (lipid-rich necrotic core [LRNC] volume, fibrous cap [FC] status, and presence of intraplaque hemorrhage [IPH]) were assessed. All patients also underwent brain MRI at baseline and after one year. Ipsilateral cerebral WMLs were quantified with a semiautomatic method.
  
  
  RESULTS
  Mean WML volume significantly increased over a one-year period (6.52 vs. 6.97 mm(3), P = 0.005). WML volume at baseline and WML progression did not significantly differ (P>0.05) between patients with 30-49% and patients with 50-69% stenosis. There was a significant correlation between total plaque volume and baseline ipsilateral WML volume (Spearman ρ = 0.393, P = 0.005). There was no significant correlation between total plaque volume and ipsilateral WML progression. There were no significant associations between LRNC volume and WML volume at baseline and WML progression. WML volume at baseline and WML progression did not significantly differ between patients with a thick and intact FC and patients with a thin and/or ruptured FC. WML volume at baseline and WML progression also did not significantly differ between patients with and without IPH.
  
  
  CONCLUSIONS
  The results of this study indicate that carotid plaque burden is significantly associated with WML severity, but that there is no causal relationship between carotid plaque vulnerability and the occurrence of WMLs.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands. eline.kooi@mumc.nl
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kwee
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.forename: Ed H B M
authors.initials: EH
authors.lastname: Gronenschild
authors.forename: Robert J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
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: M Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis / Q000473:pathology*