Is Carotid Plaque Contrast Enhancement on MRI Predictive for Cerebral or Cardiovascular Events? A Prospective Cohort Study.
OBJECTIVE
The aim of this study was to correlate carotid plaque contrast enhancement (CPCE) to onset of cerebral/cardiovascular events (CCVE) in patients with atherosclerotic carotid disease.


METHODS
The ethics committee approved this prospective study. Patients with carotid artery stenosis underwent magnetic resonance angiography before/after injection of 0.1 mmol/kg of gadobenate dimeglumine. Carotid plaque contrast enhancement was graded as follows: 0, no CPCE; 1, 1 single enhancement focus; 2, 2 or more foci.


RESULTS
Seventy-seven patients (71 ± 9 years) had a stenosis degree: 34 mild, 16 moderate, 27 severe at the right side, and 36, 15, and 25 at the left side. Carotid plaque contrast enhancement was 0 in 30 patients, 1 in 26, 2 in 11 at the right, and 37, 19, and 13 at the left. Forty-seven CCVE occurred after magnetic resonance imaging, correlated to both stenosis degree (P = 0.006) and CPCE (P = 0.032). Excluding surgery/stenting, the correlation held only for CPCE (P = 0.017). Of 49 patients showing CPCE, 5 (10%) reported CCVE; of 21 patients without CPCE, none reported CCVE (P = 0.129).


CONCLUSIONS
The absence of CPCE seems to be a negative predictor for CCVE.
From the *Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; †Unità Operativa di Radiologia Diagnostica e Interventistica, Azienda Ospedaliera San Paolo, Milan, Italy; ‡Vascular Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; and §Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, San Donato Milanese, Italy.
Giacomo Davide Edoardo
GD
Papini
Giovanni
G
Di Leo
Michele
M
Bandirali
Biagio
B
Cotticelli
Nicola
N
Flor
Pietro
P
Restivo
Giovanni
G
Nano
Francesco
F
Sardanelli
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine