MRI Research Today is a free monthly online journal that collates and summarizes the latest research about MRI, including details on magnetic resonance imaging, neuroimaging, brain tumors. | ||||||||
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Detection of unstable carotid artery stenosis using MRI.Esposito L, Sievers M, Sander D, Heider P, Wolf O, Greil O, Zimmer C, Poppert H Dept. of Neurology, Klinikum rechts der Isar, Technical University of Munich, Moehlstrasse 28, 81675, Munich, Germany, Poppert@neuro.med.tu-muenchen.de. BACKGROUND AND PURPOSE : Carotid artery stenosis can be classified by magnetic resonance imaging (MRI) as lesion types I-VIII according to a modified histological scheme based on American Heart Association (AHA) guidelines. Lesion types IV-V and VI are regarded as high-risk plaques.We aimed to evaluate the clinical relevance of this classification for identifying unstable plaques. METHODS : Eighty-five patients (29 female) with severe carotid artery stenosis (diagnosed by Doppler and duplex ultrasonography) were imaged using a 1.5 T scanner with bilateral phased-array carotid coils. T1-, T2-, time-offlight (TOF) and proton-density (PD)-weighted studies were obtained. The carotid plaques were classified as lesion types III-VIII according to the MRI-modified AHA criteria. RESULTS : Thirty-five patients presented with a recently symptomatic stenosis; 50 patients were asymptomatic. Lesion types IV-V (51.4 % vs. 22 %) and VI (20 % vs. 4%; P < 0.0001) were found significantly more often in symptomatic patients compared to those without a history of cerebral ischemia. CONCLUSIONS : The distribution of lesion types differs significantly between symptomatic and asymptomatic carotid artery stenosis. High-risk lesion types IV-V and VI were overrepresented in recently symptomatic patients. MRI according to the modified AHA-criteria may be a suitable tool for detection of unstable carotid lesions. Published 3 January 2008 in J Neurol, 254(12): 1714-22.
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