What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Carotid artery plaque and acute ischemic cerebrovascular disease (n=72). Intervention: Symptomatic acute ischemic cerebrovascular disease vs. Asymptomatic group. Primary outcome: Proportion of patients with vulnerable plaque (p=<0.05).

August 3, 2020Open Access

Significance of high resolution MRI in the identification of carotid plaque

Q: What are the key findings of this study?

The proportion of patients with vulnerable carotid plaque identified by high-resolution MRI was significantly higher in the symptomatic group compared to the asymptomatic group (75.0% vs 47.2%, P<0.05).

YSYong SunMinistry of Education of the People's Republic of China LXLei XuHarbin University of Science and Technology YJYan JiangShanghai Jiao Tong University

Key Result

The proportion of patients with vulnerable carotid plaque identified by high-resolution MRI was significantly higher in the symptomatic group compared to the asymptomatic group (75.0% vs 47.2%, P<0.05).

Study Design

Type

Cross-Sectional (n=72)

Multicenter

Structured PICO

Does high-resolution MRI improve the identification and quantification of vulnerable carotid plaque compared to carotid ultrasound in patients with acute ischemic cerebrovascular disease?

Population

72 patients aged 45 to 82 years with carotid plaque and varying degrees of stenosis, evaluated using high-resolution MRI to identify vulnerable plaque characteristics.

Exposure

High-resolution magnetic resonance imaging (HR-MRI) of carotid artery plaque

Comparator

Carotid ultrasound

Outcome

Identification and quantification of vulnerable carotid plaque componentssurrogate

Main Result

Absolute Event Rate: 75% vs 47.2%

p-value: p=<0.05

Limitations

Patients did not undergo a follow-up examination at a later stage to assess prognosis.
Small sample size, which may introduce bias.
Lack of a pathological gold standard as a validation tool, as patients did not undergo endometrial exfoliation treatment.

Abstract

The stability of carotid artery plaque serves a key role in the occurrence of stroke. The present study was based on the recruitment of patients with acute ischemic cerebrovascular disease. High-resolution magnetic resonance imaging (HR-MRI) was used to identify the nature of carotid artery plaque, and the results were then used to manage the high-risk group of stroke. The patients were divided equally into a symptomatic group (36 cases) and an asymptomatic group (36 cases). According to the degree of carotid artery stenosis, the patients were divided into mild, moderate and severe stenosis groups, each group comprising 12 patients, and HR-MRI was performed. The proportion of patients with vulnerable plaque in the symptomatic group was higher compared with that in the asymptomatic group (P<0.05). The more severe the stenosis, the higher the proportion of vulnerable plaque that was identified (P<0.05). Compared with carotid ultrasound, HR-MRI was indicated to have the capability to both identify and quantify the different components in the plaque, allowing an assessment of its properties. In conclusion, the present study demonstrated that carotid HR-MRI is able to distinguish and quantify the different components of plaque, which may prove to be helpful for the hierarchical management of a population at high risk of stroke.

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