Co-existing intracranial and extracranial carotid artery atherosclerotic plaques and recurrent stroke risk: a three-dimensional multicontrast cardiovascular magnetic resonance study

Journal of Cardiovascular Magnetic Resonance

Research

Le He¹  Zechen Zhou¹  Rui Li¹  Xihai Zhao²  Chun Yuan³  Donghua Mi⁴  Yilong Wang⁵  Yongjun Wang⁵  Gaifen Liu⁵  Yilan Xu⁶  Zhuozhao Zheng⁶  Yuanyuan Cui⁷ 

[1] Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China;Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China;Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China;Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Haidian District, 100084, Beijing, China;Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China;Department of Radiology, University of Washington, Seattle, WA, USA;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China;Department of Radiology, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China;Department of Radiology, PLA General Hospital, Beijing, China;

关键词: Intracranial artery;    Carotid artery;    Atherosclerosis;    Cardiovascular magnetic resonance;    Recurrent stroke;   

DOI  :  10.1186/s12968-016-0309-3

 received in 2016-11-02, accepted in 2016-11-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAs a systemic disease, atherosclerosis commonly affects intracranial and extracranial carotid arteries simultaneously which is defined as co-existing plaques. Previous studies demonstrated that co-existing atherosclerotic diseases are significantly associated with ischemic cerebrovascular events. The aim of this study was to investigate the characteristics of co-existing intracranial and extracranial carotid atherosclerotic plaques and their relationships with recurrent stroke by using 3D multi-contrast magnetic resonance (MR) vessel wall imaging.MethodsPatients with recent cerebrovascular symptoms in anterior circulation and at least one carotid plaque were recruited. All patients underwent cardiovascular magnetic resonance (CMR) for brain and intracranial and extracranial arteries. Presence/absence of atherosclerotic plaque at each arterial segment was identified. The maximum wall thickness (Max WT), length, stenosis of each plaque was measured. The presence/absence of calcification, lipid-rich necrotic core (LRNC), and intraplaque hemorrhage (IPH) was assessed. Cerebral old and acute infarcts in anterior circulation were evaluated.ResultsFifty-eight patients (mean age: 58.0 ± 8.5 years old, 34 males) were recruited. Of the 58 patients, co-existing intracranial and extracranial carotid artery plaques were found in 45 patients (77.6%), of which 7 (15.6%) had first time acute stroke and 26 (57.8%) had recurrent stroke. For these 33 patients with stroke, the number of intracranial plaques (OR = 11.26; 95% CI, 1.27–100; p = 0.030) and co-existing intracranial and extracranial carotid artery plaques (OR = 2.42; 95% CI, 1.04–5.64; p = 0.040) was significantly associated with recurrent stroke. After adjusting for traditional risk factors, the number of co-existing plaques was still significantly correlated with recurrent stroke (OR = 3.31; 95% CI, 1.09–10.08; p = 0.035). No correlations were found between recurrent stroke and Max WT, length, stenosis, and compositions of plaques.ConclusionsCo-existing intracranial and extracranial carotid artery plaques are prevalent in symptomatic patients and the number of co-existing plaques is independently associated with the risk of recurrent stroke.

【 授权许可】

CC BY   
© The Author(s). 2016