- Poster presentation
- Open Access
- Published:
Prevalence of complicated carotid atherosclerotic plaques ispilateral to ischemic cryptogenic stroke using high-resolution mri
Journal of Cardiovascular Magnetic Resonance volume 13, Article number: P379 (2011)
Introduction
Although distinct pathogenetic mechanisms for ischemic stroke have long been recognized, a definite or even probable etiology can not be established in about one third of all patients (“cryptogenic strokes”). Recent studies have shown that high-resolution carotid MRI is able to identify complicated American Heart Association lesion type VI (AHA-LT6) with hemorrhage, thrombus or rupture of the fibrous cap with good correlation to histopathology.
Purpose
The purpose of our study was to evaluate the prevalence of AHA-LT6 in carotid arteries of subjects with cryptogenic stroke.
Methods
30 consecutive patients (24 men, mean age 69.9 ± 11.9 years) with cryptogenic stroke and intimal thickening by duplex sonography were recruited from our stroke unit. All patients underwent extensive clinical workup (lab, brain MRI, duplex sonography, 24-hour ECG, transesophageal echocardiography) to exclude carotid stenosis ≥ 50%, cardiac embolism, small vessel disease and other causes of stroke. All subjects received a high-resolution carotid black-blood MRI at 3.0-Tesla with fat-saturated pre- and post-contrast T1w-, PDw-, T2w- and TOF images using surface coils and Parallel Imaging techniques (PAT factor=2). Prevalence of AHA-LT6 was determined in both carotid arteries based on previously published MRI criteria by two experienced reviewers who were blinded to the clinical information.
Results
AHA-LT6 with hemorrhage, rupture of the fibrous cap and / or thrombus were found in 14 out of 30 arteries (46.7%) ipsilateral and in 1 out of 30 arteries (3.3%) contralateral to the ischemic, “cryptogenic” stroke (P<0.001). Of the 15 plaques classified as AHA-LT6, 13 had plaque hemorrhage, 2 had mural thrombi and 8 a rupture of the fibrous cap. Figure 1.
Images of a non-obstructive complicated AHA lesion type VI of a 66-year old male patient with a ,,cryptogenic“stroke ipsilateral to the lesion. The triangles on the TOF and PDw Images point to the site of the plaque rupture. The arrows point to a large lipid/necrotic core with type I Hemorrhage which does not cause substantial luminal narrowing (see TOF images on the left).
Conclusions
Complicated non-stenotic carotid atherosclerotic lesions were found significantly more often ipsilateral than contralateral to ischemic “cryptogenic” stroke.
Author information
Affiliations
Corresponding author
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Saam, T., Freilinger, T., Schindler, A. et al. Prevalence of complicated carotid atherosclerotic plaques ispilateral to ischemic cryptogenic stroke using high-resolution mri. J Cardiovasc Magn Reson 13, P379 (2011). https://doi.org/10.1186/1532-429X-13-S1-P379
Published:
Keywords
- Carotid Stenosis
- Duplex Sonography
- Cryptogenic Stroke
- Carotid Atherosclerotic Plaque
- Parallel Image Technique
