Hyperintense Carotid Plaque on T1-Weighted Turbo-Field Echo MRI in Symptomatic Patients with Low-Grade Carotid Stenosis and Carotid Occlusion

2010 ◽  
Vol 30 (3) ◽  
pp. 221-229 ◽  
Author(s):  
Anja G. van der Kolk ◽  
Gert J. de Borst ◽  
Anne G. den Hartog ◽  
M. Eline Kooi ◽  
Willem P.T.M. Mali ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Carotid Occlusion ◽  
Low Grade ◽  
Turbo Field Echo

scholarly journals The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

2013 ◽  
Vol 70 (11) ◽  
pp. 993-998 ◽  
Author(s):  
Djordje Milosevic ◽  
Janko Pasternak ◽  
Vladan Popovic ◽  
Dragan Nikolic ◽  
Pavle Milosevic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Brain Infarction ◽  
Statistical Significance ◽  
Brain Parenchyma ◽  
Plaque Morphology ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Silent Brain Infarction

Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70%) extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%), but without a statistically significant difference (p > 0.05). The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus) showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a larger percentage of patients with silent brain infarction (36.4% : 29.3%) but without a significant statistical difference (p > 0.05). Conclusions. Even though silent brain infarction is more frequent in patients with unstable plaque of carotid bifurication, the difference is of no statistical significance. The effects of the number and type of risk factors bear no statistical significance on the incidence of morphological asymptomatic carotid plaque.

Abstract WP158: Validation of a Preliminary Prediction Model with MR Plaque Imaging to Estimate Risk for New Ischemic Brain Lesions after Carotid Endarterectomy or Stenting

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kohkichi Hosoda ◽  
Nobuyuki Akutsu ◽  
Atsushi Fujita ◽  
Eiji Kohmura
Keyword(s):  
Prediction Model ◽  
Carotid Stenosis ◽  
Predictive Value ◽  
Signal Intensity ◽  
Carotid Plaque ◽  
Brain Lesions ◽  
Black Blood ◽  
Training Set ◽  
Ischemic Brain ◽  
Validation Set

[Objective] Recently, we reported a preliminary prediction model with carotid plaque MRI to estimate risk for new ischaemic brain lesions after CEA or CAS. The objective of this study was to validate this model in new set of patients with carotid stenosis. [Methods] One hundred four patients with carotid stenosis undergoing treatment (63 CEA, 41 CAS) were used as a training set for construction of a preliminary prediction model to estimate risk for new ischemic brain lesions after CEA or CAS. T1 and T2 signal intensity of carotid plaque were measured on black-blood MRI. Associations among MRI findings, treatment, clinical factors, and occurrence of new ischemic lesions on DWI 1 day after treatment were studied by logistic regression. The validity of the prediction model was examined using a new set of patients with carotid stenosis (n = 43) as a validation set. [Results] In the training set, new DWI lesions after treatment were observed in 25 patients (24%). The model demonstrated that T1-signal intensity and CAS were positively associated with new lesions on post-treatment DWI scans, and T2 signal intensity was negatively associated (Fig. 1). The C-index was 0.79, which indicated some predictive value. In the validation set, new DWI lesions after treatment were observed in 10 patients (23%). However, C-index was 0.6 and positive predictive value was 33% (Fig. 2), which suggested overfitting of our model and/or differences in case-mix between the training set and validation set. [Conclusions] Our preliminary prediction model may provide some useful information for decision-making regarding treatment strategy, but needs further collection of patients to improve its predictive value.

3041Wall shear stress measurement by ultrafast vector flow imaging for atherosclerotic carotid stenosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Goudot ◽  
L Khider ◽  
O Pedreira ◽  
J M Poree ◽  
P Julia ◽  
...  
Keyword(s):  
Shear Stress ◽  
Carotid Artery ◽  
Wall Shear Stress ◽  
Internal Carotid Artery ◽  
Carotid Stenosis ◽  
Common Carotid Artery ◽  
Carotid Plaque ◽  
Internal Carotid ◽  
Plaque Vulnerability ◽  
Wall Shear

Abstract Background Carotid plaque vulnerability assessment is an important factor in guiding the decision to treat significant carotid stenosis. Ultrafast Ultrasound Imaging (UF) offers the possibility of evaluating local flow velocities over an entire 2D image, allowing access to velocity measurements in contact with the arterial wall and to measure the wall shear stress (WSS). Purpose To evaluate the feasibility of WSS measurement in a prospective series of patients with carotid stenosis. Methods A 7.5 MHz linear probe of an Aixplorer scanner was used. UF acquisitions had 3 tilted plane waves transmits (−10; 0; 10°) and an effective frame rate of 5000Hz. We evaluated the flow velocity in 5 areas of the carotid wall: common carotid artery (1), plaque ascent (2), plaque peak (3), plaque descent (4), internal carotid artery (5) (Figure). WSS was computed with the vector field speed using the following formula, WSS=μ·δn·v with v the blood velocity, n the normal vector to the vessel wall and μ, the blood viscosity, calculated from the hematocrit value for each patient. WSS measurement method was first validated using a laminar flow phantom and known viscosity. And then, 33 patients were then prospectively evaluated, with a median carotid stenosis degree of 80% [75–85]. Results Significant correlation was found between in vitro measurement and the theoretical WSS values (R2=0.95; p<0.001).In patients,the maximum WSS value over the cardiac cycle follows the shape of the plaque with an increase during the ascend, reaching its maximum value of 3.57 Pa [2.47–4.45] at the peak of the plaque, and a fall after passing the peak (0.99 Pa [0.8–1.32]) lower than the WSS values in the non-stenotic areas (1.55 Pa [1.13–1.90] for the common carotid artery) (Table). Table 1 Wall's area Wall shear stress (Pa) Min Max Delta 1. Common carotid artery 0.14 [0.05–0.27] 1.55 [1.13–1.90] 0.73 [0.55–0.96] 2. Plaque's ascent 0.39 [0.24–0.59] 2.63 [1.89–3.28] 1.20 [0.89–1.79] 3. Plaque's peak 0.60 [0.32–0.89] 3.57 [2.47–4.45] 1.78 [1.44–2.46] 4. Plaque's descent 0.16 [0.13–0.22] 0.99 [0.80–1.32] 0.52 [0.34–0.73] 5. Internal carotid artery 0.17 [0.13–0.35] 1.37 [1.04–1.75] 0.72 [0.50–0.87] Results are median [25th–75th percentile]. Figure 1 Conclusion UF provide reliable WSS values. High WSS was present at the peak of the plaque, whereas lowest WSS values were found at the post-stenotic zone. WSS evaluation may help to better characterize the carotid plaque vulnerability.

High intensity signal in the plaque on routine 3D-TOF MRA is associated with ischemic stroke in the patients with low-grade carotid stenosis

2018 ◽  
Vol 385 ◽  
pp. 164-167 ◽  
Author(s):  
Kiyofumi Yamada ◽  
Shinichi Yoshimura ◽  
Manabu Shirakawa ◽  
Kazutaka Uchida ◽  
Fumiaki Maruyama ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Stenosis ◽  
High Intensity ◽  
Low Grade ◽  
Tof Mra ◽  
High Intensity Signal

720 Ultrasound Features of Carotid Plaque Instability are Associated Between Sides in Patients With Bilateral Carotid Stenosis

2012 ◽  
Vol 28 (5) ◽  
pp. S375-S376
Author(s):  
R.J. Doonan ◽  
A. Dawson ◽  
J. Gorgui ◽  
Y. Gomez ◽  
C. Kwong ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Plaque Instability ◽  
Bilateral Carotid ◽  
Ultrasound Features

Microembolic signals and carotid plaque morphology: a study of 71 patients with moderate or high grade carotid stenosis

2003 ◽  
Vol 108 (2) ◽  
pp. 114-117 ◽  
Author(s):  
I. Mayor ◽  
M. Comelli ◽  
E. Vassileva ◽  
P. Burkhard ◽  
R. Sztajzel
Keyword(s):  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Plaque Morphology ◽  
High Grade

scholarly journals Detection of Unstable Plaques in Patients with Carotid Stenosis Using B-Mode Ultrasonography

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 165-170 ◽  
Author(s):  
E. Kobayashi ◽  
J. Ono ◽  
S. Hirai ◽  
I. Yamakami ◽  
N. Saeki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Heart Attack ◽  
Carotid Plaque ◽  
New Method ◽  
Color Mapping ◽  
Carotid Plaques ◽  
Unstable Plaques

Distal embolism is a detrimental complication of stent placement for the carotid artery stenosis. To evaluate usefulness of B-mode ultrasonography (US) for the detection of unstable plaques in patients with carotid artery stenosis, we examined US in 46 arteries of 35 patients with carotid stenosis of >30%. The echogenicity of 46 carotid plaques was hyperechoic in 20 plaques, hypoechoic in 15, and mixed-echoic in 11. The echogenicity of carotid plaques was correlated with severity of carotid stenosis, ipsilateral stroke or T1A, heart attack, and risk factors of systemic atherosclerosis. Hypoechoic plaques were associated with severe carotid stenosis and ipsilateral ischemic event. Mixed-echoic plaques had a high incidence of past history of heart attack. Hyperechoic plaques were less likely to associate with risk factors of systemic atherosclerosis. We developed a new method of echodensity analysis. Using a computer software, echodensity values of seven plaque components were determined by comparing US findings and pathology of surgical specimens. The echodensity value was defined as a relative value to the arterial lumen. The calcified part of plaques had the highest echodensity of 6.24 ± 0.86 (mean ± 2 S.D.); fibrosis or hyarynoid degeneration of 2.05 ± 0.40, foamy histiocytes of 1.47 ± 0.05, necrosis of 1.32 ± 0.16, cholestelin clefts of 1.28 ± 0.13, intraplaque hemorrhage of 1.02 ± 0.09, and intraluminal thrombus of 1.27 ± 0.07. Constructed from the echodensity value, an echo-densitometry color mapping of the carotid plaque illustrated the exact location and extent of plaque component. B-mode US of carotid plaques represents clinical characteristics relating distal embolism and systemic atherosclerosis. A new method of echodensity analysis and echo-densitometry color mapping of the carotid plaque is useful to detect unstable plaques in patients with carotid stenosis.

scholarly journals Carotid Plaque With High-Risk Features in Embolic Stroke of Undetermined Source

Stroke ◽  
2020 ◽  
Vol 51 (1) ◽  
pp. 311-314 ◽  
Author(s):  
Joseph Kamtchum-Tatuene ◽  
Alan Wilman ◽  
Maher Saqqur ◽  
Ashfaq Shuaib ◽  
Glen C. Jickling
Keyword(s):  
High Risk ◽  
Carotid Stenosis ◽  
Carotid Plaque ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Random Effect ◽  
Embolic Stroke ◽  
Imaging Features ◽  
Luminal Narrowing ◽  
Carotid Plaque Imaging

Background and Purpose— An ipsilateral mild carotid stenosis, defined as plaque with <50% luminal narrowing, is identified in nearly 40% of patients with embolic stroke of undetermined source and could represent an unrecognized source of atheroembolism. We aimed to summarize data about the frequency of mild carotid stenosis with high-risk features in embolic stroke of undetermined source. Methods— We searched Pubmed and Ovid-Embase for studies reporting carotid plaque imaging features in embolic stroke of undetermined source. The prevalence of ipsilateral and contralateral mild carotid stenosis with high-risk features was pooled using random-effect meta-analysis. Results— Eight studies enrolling 323 participants were included. The prevalence of mild carotid stenosis with high-risk features in the ipsilateral carotid was 32.5% (95% CI, 25.3–40.2) compared with 4.6% (95% CI, 0.1–13.1) in the contralateral carotid. The odds ratio of finding a plaque with high-risk features in the ipsilateral versus the contralateral carotid was 5.5 (95% CI, 2.5–12.0). Conclusions— Plaques with high-risk features are 5 times more prevalent in the ipsilateral compared with the contralateral carotid in embolic stroke of undetermined source, suggesting a relationship to stroke risk.

Sign in / Sign up

Export Citation Format

Share Document