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http://dx.doi.org/10.3340/jkns.2015.57.2.94

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)
Publication Information
Journal of Korean Neurosurgical Society / v.57, no.2, 2015 , pp. 94-99 More about this Journal
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
MRI; Stroke; Carotid artery; Atherosclerosis;
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