title: Plaque vulnerability in internal carotid arteries with positive remodeling.
abstract: BACKGROUND
  This study aimed to evaluate the efficacy of assessing positive remodeling for predicting future stroke events in the internal carotid artery. We therefore assessed narrowing of the carotid artery lumen using multidetector-row computer tomography (MDCT) angiography and carotid plaque characteristics using black-blood (BB) magnetic resonance (MR).
  
  
  METHODS
  We retrospectively selected 17 symptomatic and 11 asymptomatic lesions with luminal narrowing >50%. We compared remodeling parameters of luminal stenosis (remodeling ratio, RR/remodeling index, RI) using MDCT and MR intensities of atherosclerotic plaque contents using the BB technique (relative signal intensity, rSI). We also confirmed the validity of the relationship between MR intensity and atherosclerotic plaque contents by histology. The levels of biological markers related to vessel atherosclerosis were measured.
  
  
  RESULTS
  Plaque lesions with positive remodeling in carotid arteries were associated with a significantly higher prevalence of stroke compared with plaques with negative remodeling (p < 0.05). Radiologic and histologic analyses determined that plaques with positive remodeling had higher signal intensities (with respect to their lipid-rich content or to hemorrhage) compared with negative remodeling (correlation coefficients: RI and rSI, r = 0.41, p < 0.05; RR and rSI, r = 0.50, p < 0.05). Levels of biological markers, including high-sensitivity C-reactive protein, hemoglobin A1C, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, were not useful for predicting stroke events.
  
  
  CONCLUSIONS
  The results of this study suggest that the combined analysis of RR, RI and rSI could potentially help to predict future stroke events.
authors.affiliation: Department of Neurology, Nagoya City University, Nagoya, Japan.
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Miura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Matsukawa
authors.forename: Keita
authors.initials: K
authors.lastname: Sakurai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katano
authors.forename: Yoshino
authors.initials: Y
authors.lastname: Ueki
authors.forename: Kenji
authors.initials: K
authors.lastname: Okita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamada
authors.forename: Kosei
authors.initials: K
authors.lastname: Ojika