Effect Of Low Dose Rosuvastatin Therapy For Carotid Atherosclerotic Plaque:a High-Resolution Magnetic Resonance Imaging Study

Purpose: To evaluate the effect of low dose rosuvastatin therapy for carotidatherosclerotic plaque by routine MRI.Methods: Patients with＞15%carotid artery stenosis confirmed by MRI and withlow density lipoprotein-cholesterol ranging from2.Ommol/L to6.5mmol/L and totalcholesterol lower than4.Ommol/L were enrolled in the serial study. All patientsreceived intensive low dose rosuvastatin lipid-lowering therapy to obtain targeted low-density lipoprotein cholesterol levels, and had serial carotid artery MR imagingexaminations in the baseline and3months,12months and24months after treatment.Plaque with the largest lipid-rich necrotic core (LRNC) in bilateral carotid arterieswas chosen as the evaluation subject and all the MR images of these four examinationtime points were matched. The changes in total vessel wall volume (WV) and LRNCvolume during lipid-lowering therapy were analyzed.Results: MR images of32patients were analyzed for the final results. After2yearsof lipid-lowering therapy, the LRNC at baseline had a signifcant reduction: LRNCvolume decreased from111.5±104.18mm3to97.74±91.52mm3, with a reduction of10.7%（p=0.035）; LRNC%(LRNC area/wall area in the lipid-rich regions) decreasedfrom18.9±11.9%mm3to16.7±11.3%, with a reduction of2.2%（p=0.027）; wallvolume decreased slightly by0.3%(baseline point:533.31±208.91mm3vs. end point:528.04±198.86mm3, p=0.530）; lumen volume decreased slightly by0.7%(baselinepoint:522.1±246.7mm3vs end point:537.6±265.0mm3, p=0.286).Conclusion: Low dose rosuvastatin therapy can signifcantly decrease the volume of LRNC of carotid plaque and slow down the progression of the carotid atherosclerosis. Purpose：To evaluate the effect of low dose rosuvastatin therapy for carotidatherosclerotic plaque by dynamic contrast-enhanced MRI (DCE-MRI).Methods: Patients with＞15%carotid artery stenosis confirmed by MRI and withlow density lipoprotein-cholesterol ranging from2.Ommol/L to6.5mmol/L and totalcholesterol lower than4.Ommol/L were enrolled in the serial study. All patientsreceived intensive low dose rosuvastatin lipid-lowering therapy to obtain targetedlow-density lipoprotein cholesterol levels, and had serial carotid artery MR imagingexaminations at the baseline and3months,12months and24months after treatment.Plaque with the largest lipid-rich necrotic core (LRNC) in bilateral carotid arterieswas chosen as the evaluation subject and all the DCE-MRI images of these fourexamination time points were matched. The DCE-MRI images were analyzed using acustom-designed image analysis software package, and according to changes of arteryadventitial perfusion parameters such as Ktransand Vpgenerated by the software,adventitial vasa vasorum in the vessel wall was analyzed during the low doserosuvastatin therapy.Results: MR images of32patients were analyzed for the final results. The carotidartery adventitial Vpvalue at four time points were0.12±0.06,0.09±0.05,0.07±0.04and0.06±0.05, respectively. The reduction percents were25.0%,22.2%,14.3%andthe differenes were statistically signifcant; after3months of lipid-lowering therapy,adventitial Ktransdramticaly increased from0.061to0.074(p>0.05), and decreased by4.1%at time point3(Ktrans=0.71), by12.7%at time point4(Ktrans=0.62).Conclusion：DCE-MRI can investigate the efficacy of lipid-lowering therapy inatherosclerosis. During low dose rosuvastatin therapy, the perfusion parameters of theadventitial vasa vasorum in the vessel wall decreased.