title: MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence.
abstract: OBJECTIVE
  To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients.
  
  
  METHODS
  One hundred twenty-six TIA/stroke patients with ipsilateral 30-69% carotid stenosis underwent multisequence carotid plaque MRI. The presence of a lipid-rich necrotic core (LRNC), fibrous cap (FC) status, and intraplaque hemorrhage (IPH) were assessed. Patients were followed to determine the recurrence of ipsilateral TIA and/or stroke within 1 year after inclusion.
  
  
  RESULTS
  Thirteen patients suffered from recurrent ipsilateral clinical ischemic events (10 TIAs and 3 strokes). Carotid stenosis grade was not associated with recurrent events (hazard ratio [HR] for 50-69% versus 30-49% stenosis = 1.198; 95% confidence interval [CI], 0.383 to 3.749; P = 0.756). The presence of an LRNC (HR = 3.2001; 95% CI, 1.078 to 9.504; P = 0.036), a thin and/or ruptured FC (HR = 5.756; 95% CI, 1.913 to 17.324; P = 0.002), and IPH (HR = 3.542; 95% CI, 1.058 to 11.856; P = 0.040) were associated with recurrence.
  
  
  CONCLUSIONS
  The presence of MRI-depicted LRNC, a thin and/or ruptured FC, and IPH are associated with the recurrence of clinical cerebrovascular ischemic events in TIA and stroke patients with carotid atherosclerosis.
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: 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: M Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000473:pathology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology*