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Association of Carotid Intraplaque Hemorrhage and Territorial Acute Infarction in Patients with Acute Neurological Symptoms Using Carotid Magnetization-Prepared Rapid Acquisition with Gradient-Echo

  • Park, Jung Soo (Department of Neurosurgery, Chonbuk National University Medical School and Hospital) ;
  • Kwak, Hyo Sung (Department of Radiology, Chonbuk National University Medical School and Hospital) ;
  • Lee, Jong Myong (Department of Neurosurgery, Chonbuk National University Medical School and Hospital) ;
  • Koh, Eun Jeong (Department of Neurosurgery, Chonbuk National University Medical School and Hospital) ;
  • Chung, Gyung Ho (Department of Radiology, Chonbuk National University Medical School and Hospital) ;
  • Hwang, Seung Bae (Department of Radiology, Chonbuk National University Medical School and Hospital)
  • Received : 2014.07.14
  • Accepted : 2014.10.22
  • Published : 2015.02.28

Abstract

Objective : The purpose of our study was to assess prevalence of carotid intraplaque hemorrhage (IPH) and associations between territorial acute infarction and IPH on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) in patients with acute neurologic symptoms. Methods : 83 patients with suspected acute neurologic symptoms were evaluated with both brain diffusion weighted imaging (DWI) and carotid MPRAGE sequences. Carotid plaque with high signal intensity on MPRAGE of >200% that of adjacent muscle was categorized as IPH. We analyzed the prevalence of IPH and its correlation with territorial acute infarction. Results : Of 166 arteries, 39 had a carotid artery plaque. Of these arteries, 26 had carotid artery stenosis less than 50%. In all carotid arteries, MR-depicted IPH was found in 7.2% (12/166). High-signal intensity on DWI was found in 17.5% (29/166). Combined lesion with ipsilateral high-signal intensity on DWI and IPH on carotid MPRAGE sequence was found in 6 lesions (6/166, 3.6%). Of patients with carotid artery plaque, MR-predicted IPH was found in 30.8% (12/39) and match lesions with high-signal intensity on DWI and MPRAGE was found in 15.4% (6/39). MR-predicted IPH was significantly higher prevalence in high-grade stenosis group (p=0.010). Relative risk between carotid MPRAGE-positive signal and ipsilateral high-signal intensity on DWI in arteries with carotid artery plaques was 6.8 (p=0.010). Conclusion : Carotid MPRAGE-positive signal in patients was associated with an increased risk of territorial acute infarction as detected objectively by brain DWI. The relative risk of stroke was increased in high-grade stenosis categories.

Keywords

References

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