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Detection of unstable carotid artery stenosis using MRI

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Abstract

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.

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Authors and Affiliations

  1. Dept. of Neurology, Klinikum rechts der Isar, Technical University of Munich, Moehlstrasse 28, 81675, Munich, Germany

    L. Esposito MD, M. Sievers & H. Poppert MD

  2. Dept. of Neurology, Medical Park Loipl, Thanngasse 15, 83483, Bischofswiesen, Germany

    D. Sander MD

  3. Dept. of Vascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany

    P. Heider MD & O. Wolf MD

  4. Dept. of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Moehlstrasse 28, 81675, Munich, Germany

    O. Greil MD & C. Zimmer MD

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  1. L. Esposito MD
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  2. M. Sievers
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Correspondence to H. Poppert MD.

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Esposito, L., Sievers, M., Sander, D. et al. Detection of unstable carotid artery stenosis using MRI. J Neurol 254, 1714–1722 (2007). https://doi.org/10.1007/s00415-007-0634-4

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  • DOI: https://doi.org/10.1007/s00415-007-0634-4

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