MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence

R.M. Kwee, Robert Jan van Oostenbrugge, W.H. Mess, M.H. Prins, R.J. van der Geest, J.W. Ter Berg, CL. Franke, A.G. Korten, B.J. Meems, J.M. van Engelshoven, J.E. Wildberger, M.E. Kooi

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Abstract

PURPOSE: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. MATERIALS AND 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. CONCLUSION: 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. J. Magn. Reson. Imaging 2013;.
Original languageEnglish
Pages (from-to)1189-1194
Number of pages6
JournalJournal of Magnetic Resonance Imaging
Volume37
Issue number5
DOIs
Publication statusPublished - May 2013

Keywords

  • carotid atherosclerosis
  • TIA
  • stroke
  • plaque
  • MRI
  • INTRAPLAQUE HEMORRHAGE
  • SYMPTOMATIC PATIENTS
  • FIBROUS CAP
  • PLAQUE
  • STENOSIS
  • ENDARTERECTOMY
  • ASSOCIATION
  • EVENTS
  • TRIALS
  • MILD

Cite this

Kwee, R.M. ; van Oostenbrugge, Robert Jan ; Mess, W.H. ; Prins, M.H. ; van der Geest, R.J. ; Ter Berg, J.W. ; Franke, CL. ; Korten, A.G. ; Meems, B.J. ; van Engelshoven, J.M. ; Wildberger, J.E. ; Kooi, M.E. / MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence. In: Journal of Magnetic Resonance Imaging. 2013 ; Vol. 37, No. 5. pp. 1189-1194.
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title = "MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence",
abstract = "PURPOSE: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. MATERIALS AND 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. CONCLUSION: 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. J. Magn. Reson. Imaging 2013;.",
keywords = "carotid atherosclerosis, TIA, stroke, plaque, MRI, INTRAPLAQUE HEMORRHAGE, SYMPTOMATIC PATIENTS, FIBROUS CAP, PLAQUE, STENOSIS, ENDARTERECTOMY, ASSOCIATION, EVENTS, TRIALS, MILD",
author = "R.M. Kwee and {van Oostenbrugge}, {Robert Jan} and W.H. Mess and M.H. Prins and {van der Geest}, R.J. and {Ter Berg}, J.W. and CL. Franke and A.G. Korten and B.J. Meems and {van Engelshoven}, J.M. and J.E. Wildberger and M.E. Kooi",
year = "2013",
month = "5",
doi = "10.1002/jmri.23918",
language = "English",
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pages = "1189--1194",
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Kwee, RM, van Oostenbrugge, RJ, Mess, WH, Prins, MH, van der Geest, RJ, Ter Berg, JW, Franke, CL, Korten, AG, Meems, BJ, van Engelshoven, JM, Wildberger, JE & Kooi, ME 2013, 'MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence', Journal of Magnetic Resonance Imaging, vol. 37, no. 5, pp. 1189-1194. https://doi.org/10.1002/jmri.23918

MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence. / Kwee, R.M.; van Oostenbrugge, Robert Jan; Mess, W.H.; Prins, M.H.; van der Geest, R.J.; Ter Berg, J.W.; Franke, CL.; Korten, A.G.; Meems, B.J.; van Engelshoven, J.M.; Wildberger, J.E.; Kooi, M.E.

In: Journal of Magnetic Resonance Imaging, Vol. 37, No. 5, 05.2013, p. 1189-1194.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - MRI of carotid atherosclerosis to identify TIA and stroke patients who are at risk of a recurrence

AU - Kwee, R.M.

AU - van Oostenbrugge, Robert Jan

AU - Mess, W.H.

AU - Prins, M.H.

AU - van der Geest, R.J.

AU - Ter Berg, J.W.

AU - Franke, CL.

AU - Korten, A.G.

AU - Meems, B.J.

AU - van Engelshoven, J.M.

AU - Wildberger, J.E.

AU - Kooi, M.E.

PY - 2013/5

Y1 - 2013/5

N2 - PURPOSE: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. MATERIALS AND 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. CONCLUSION: 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. J. Magn. Reson. Imaging 2013;.

AB - PURPOSE: To evaluate the potential of carotid plaque MRI to predict transient ischemic attack (TIA) and stroke recurrence in previously symptomatic patients. MATERIALS AND 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. CONCLUSION: 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. J. Magn. Reson. Imaging 2013;.

KW - carotid atherosclerosis

KW - TIA

KW - stroke

KW - plaque

KW - MRI

KW - INTRAPLAQUE HEMORRHAGE

KW - SYMPTOMATIC PATIENTS

KW - FIBROUS CAP

KW - PLAQUE

KW - STENOSIS

KW - ENDARTERECTOMY

KW - ASSOCIATION

KW - EVENTS

KW - TRIALS

KW - MILD

U2 - 10.1002/jmri.23918

DO - 10.1002/jmri.23918

M3 - Article

VL - 37

SP - 1189

EP - 1194

JO - Journal of Magnetic Resonance Imaging

JF - Journal of Magnetic Resonance Imaging

SN - 1053-1807

IS - 5

ER -