Characteristics Of Carotid Atherosclerotic Plaques Between Symptomatic And Asymptomatic Sides: A High-resolution Magnetic Resonance Imaging Study

Characteristics of magnetic resonance imaging of carotidatherosclerosis scoreObjective: To investigate the relationships of carotid atherosclerosis score (CAS) withcarotid atherosclerotic disease and clinical indexs in ischemic patients.Materials and Methods: Patients with recent (<2weeks) diagnostic stroke or transientischemic attack (TIA) were recruited in this study. All patients were receivedhigh-resolution MR examination of bilateral carotid arteries. The carotidatherosclerotic luminal stenosis, maximum wall thickness (MaxWT) and lesion lengthwere measured. The carotid plaques without intraplaque hemorrhage (IPH) and fibrouscap rupture (FCR) were analyzed using CASCAD software. The CAS value wasderived from the ratio of lipid-rich core area occupied in wall area, the lipid-rich coreand wall areas were obtained in the maximum plaque layer. The value of0%,0%-20%,20%-40%and>40%were defined as CAS grade one, two, three and four, respectively.The CAS grade one and two were defined as low-risk group, the three and four werehigh-risk group. The correlation between CAS and carotid atherosclerotic disease wasevaluated. The patients without IPH and FCR in bilateral carotid plaques were selectedto evaluate the relationship between CAS and clinical indexs.Results:96cases (mean age was63.5±12.3years old) were recruited in this research.148carotid arteries showed no hemorrhage and FCR in the plaques and the CAS value was21.6%±17.5. The correlations between CAS and carotid luminal stenosis, MaxWTand lesion length were r=0.610, P<0.05; r=0.569, P<0.05and r=0.527, P<0.05,respectively. The differences of carotid luminal stenosis, MaxWT and lesion lengthamong different CAS grades had statistical significances (P<0.05).62patients showedno hemorrhage and FCR in bilateral carotid plaques. The correlations of CAS valuewith low density lipoprotein (LDL) and the ratio of high density lipoprotein (HDL) totriglycerid were r=0.469, P<0.001and r=－0.269, P=0.035<0.05. The differences ofsystolic pressure, diastolic pressure and LDL in low-risk and high-risk had statisticalsignificance (P<0.05).Conclusions: The relationships of CAS with carotid atherosclerotic disease and lipidmetabolism were close. The occurrence rates of IPH and FCR in carotid plaques aremore common with the increasing of CAS grade. Differences of Carotid Atherosclerotic Plaques between Symptomaticand Asymptomatic Sides in Cerebral Ischemic Patients Using3.0THigh-Resolution MR ImagingObjective: Using3.0T high-resolution MR imaging to investigate the differences ofcarotid atherosclerotic (AS) plaques between symptomatic and asymptomatic sides incerebral ischemic patients.Materials and Methods: Patients with recent (<two weeks) infarction or transientischemic attack (TIA) were recruited in our study. Each patient was suffered fromunilateral limb symptoms (acute limb weakness or numbness) and receivedhigh-resolution MR examination of bilateral carotid arteries. The carotidatherosclerotic luminal stenosis, maximum wall thickness (MaxWT) and lesion lengthwere measured and the intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC)and fibrous cap rupture (FCR) were evaluated. The differences of carotidatherosclerotic plaques between symptomatic and asymptomatic sides wereinvestigated. The patients without IPH and FCR in bilateral carotid plaques wereselected to evaluate the difference of CAS in symptomatic and asymptomatic sides.Results: Of102cerebral ischemic patients (the age was65.5±13.2),52had infarctionand50developed TIA. Comparing the carotid atherosclerotic plaques betweensymptomatic and asymptomatic sides, the luminal stenosis were30.0%±31.9%and25.6%±20.9%, respectively. It showed no difference (P>0.05). The MaxWT were3.2±1.8mm and2.2±1.7mm, the lesion length were2.5±1.5cm and1.7±1.5cm. TheMaxWT and lesion length had significant statistic differences (P<0.001). Theoccurrence rates of vulnerable compositions such as hemorrhage, lipid-rich core andfibrous cap rupture in symptomatic sides were54.9%,56.9%and48.0%, respectively.They were obviously higher than those in asymptomatic sides (12.7%,14.7%and3.9%)and showed significant statistic difference (P<0.001). The grade0of plaque was defined when the plaque showed no vulnerable composition and the grade1wasdefined when the plaque had one vulnerable composition and so on. The grade ofcarotid plaque in symptomatic side was obviously higher than the asymptomatic side(Z=﹣6.525, P<0.001).62patients showed no hemorrhage and FCR in bilateral carotidplaques. The CAS value in symptomatic and asymptomatic sides were24.5%±17.0%and18.0%±17.9%, and the difference had statistical significance (P=0.005<0.05).The differences of CAS grades in symptomatic and asymptomatic sides also hadstatistical significance (P=0.015<0.05).Conclusion: Among ischemic patients with unilateral limb symptoms, the severity andvulnerability of carotid atherosclerotic plaques in symptomatic sides are obviouslyhigher than the asymptomatic sides. The CAS grade in symptomatic side is obviouslyhigher than the asymptomatic side.