title: Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging.
abstract: BACKGROUND
  Cilostazol, an antiplatelet agent, is reported to induce the regression of atherosclerotic changes. However, its effects on carotid plaques are unknown. Hence, we quantitatively investigated the changes that occur within carotid plaques during cilostazol administration using three-dimensional (3D) ultrasonography (US) and non-gated magnetic resonance (MR) plaque imaging.
  
  
  METHODS
  We prospectively examined 16 consecutive patients with carotid stenosis. 3D-US and T1-weighted MR plaque imaging were performed at baseline and 6 months after initiating cilostazol therapy (200 mg/day). We measured the volume and grayscale median (GSM) of the plaques from 3D-US data. We also calculated the contrast ratio (CR) of the carotid plaque against the adjacent muscle and areas of the intraplaque components: fibrous tissue, lipid, and hemorrhage components.
  
  
  RESULTS
  The plaque volume on US decreased significantly (median at baseline and 6 months, 0.23 and 0.21 cm(3), respectively; p = 0.03). In the group exhibiting a plaque volume reduction of more than 10%, GSM on US increased significantly (24.8 and 71.5, respectively; p = 0.04) and CR on MRI decreased significantly (1.13 and 1.04, respectively; p = 0.02). In this group, in addition, the percent area of the fibrous component on MRI increased significantly (68.6% and 79.4%, respectively; p = 0.02), while those of the lipid and hemorrhagic components decreased (24.9% and 20.5%, respectively; p = 0.12) (1.0% and 0.0%, respectively; p = 0.04). There were no substantial changes in intraplaque characteristics in either US or MRI in the other group.
  
  
  CONCLUSIONS
  3D-US and MR plaque imaging can quantitatively detect changes in the size and composition of carotid plaques during cilostazol therapy.
authors.affiliation: Department of Neurology and Gerontology, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohba
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Mori
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Narumi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsura
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Ohura
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terayama
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D000077407:Cilostazol; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D012372:ROC Curve; D018709:Statistics, Nonparametric; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol