title: Longitudinal MRI study on the natural history of carotid artery plaques in symptomatic patients.
abstract: OBJECTIVE
  To investigate the natural history of carotid atherosclerosis in patients who experienced a TIA or ischemic stroke.
  
  
  METHODS
  Ninety-two TIA/stroke patients (57 men, mean age 67.7 ± 9.8 years) with ipsilateral <70% carotid stenosis underwent multisequence MRI of the plaque ipsilateral to the symptomatic side at baseline and after one year. For each plaque, several parameters were assessed at both time points.
  
  
  RESULTS
  Carotid lumen, wall and total vessel ( = carotid lumen and wall) volume did not significantly change. Forty-four patients had a plaque with a lipid-rich necrotic core (LRNC) at baseline, of which 34 also had a LRNC after one year. In three patients a LRNC appeared after one year. Thirty patients had a plaque with a thin and/or ruptured fibrous cap (FC) at both time points. In seven patients, FC status changed from thin and/or ruptured into thick and intact. In three patients, FC status changed from thick and intact into thin and/or ruptured. Twenty patients had intraplaque hemorrhage (IPH) at both time points. In four patients, IPH disappeared, whereas in three patients, new IPH appeared at follow-up.
  
  
  CONCLUSIONS
  In TIA/stroke patients, carotid plaque morphology does not significantly change over a one-year period. IPH and FC status change in a minority of patients.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands. rmkwee@gmail.com
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kwee
authors.forename: Martine T B
authors.initials: MT
authors.lastname: Truijman
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: Cees L
authors.initials: CL
authors.lastname: Franke
authors.forename: Arthur G G C
authors.initials: AG
authors.lastname: Korten
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: M Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged