title: [Carotid MRI of initial and recurrent plaques in patients with restenosis after endarterectomy: three case reports].
abstract: Restenosis after carotid endarterectomy (CEA) is one of most significant complications. There is no previous report about MRI findings of restenotic lesions and preoperative plaques. The purpose of this study was to evaluate the initial and recurrent plaques in patients with restenosis after CEA by using black-blood MRI (BB-MRI). Three patients who underwent carotid artery stenting for restenosis after CEA were included in this study. The relative signal intensities (rSI) of the initial and recurrent plaques were calculated with reference to the sternocleidomastoid muscle on T1-weighted images (T1WI) and the submandibular gland on T2-weighted images (T2WI). This study investigated the rSI characteristics and morphology of the initial and recurrent plaques. All patients had restenosis within 1 year after CEA. The rSI values of the preoperative lesion were not high on T1WI and were high on T2WI in all cases (T1WI/T2WI: 0.63/2.43 in Case 1, 1.00/1.29 in Case 2, and 1.13/1.70 in Case 3). The morphology of the initial plaques was eccentric in 2 cases and concentric in 1 case. The rSI values of restenosis were high on T2WI in all cases (T1WI/T2WI: 1.09/1.20 in Case 1, 1.31/1.50 in Case 2, and 1.23/1.70 in Case 3). The morphology of restenotic lesions was concentric in all cases. The high rSI on T2WI and concentricity of the restenosis after CEA suggest early restenosis (intimal hyperplasia). The low-iso rSI on T1WI and high rSI on T2WI of the preoperative plaques are associated with restenosis after CEA. BB-MRI may be useful to evaluate and predict restenosis after CEA. (Received: May 7, 2012, Accepted: September 10, 2012).
authors.affiliation: Department of Neurosurgery, Nakamura Memorial Hospital, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Endo
authors.forename: Kenji
authors.initials: K
authors.lastname: Kamiyama
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takahira
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ogino
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Takada
authors.forename: Taketo
authors.initials: T
authors.lastname: Kataoka
authors.forename: Toshio
authors.initials: T
authors.lastname: Hyogo
authors.forename: Jyoji
authors.initials: J
authors.lastname: Nakagawara
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Ono
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology*; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006083:Graft Occlusion, Vascular / Q000150:complications*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011859:Radiography; D055502:Secondary Prevention; D016896:Treatment Outcome