Highlights
- •MRI detected carotid plaque high T2W signal was less common as the time from onset of a carotid-territory ischemic event increased.
- •This phenomenon was observed more frequently on the lumen surface.
- •This result raises the possibility of change of carotid plaque composition after an acute cerebrovascular ischemic event.
Abstract
Recent studies report that the rate of recurrent stroke is highest in the stages immediately
following cerebral infarction and decreases over time in patients with atherosclerotic
carotid stenosis. The purpose of this study was to identify temporal differences in
early stage carotid plaque components from acute cerebrovascular ischemic events using
carotid MRI. Carotid plaque images were obtained on 3 T MRI from 128 patients enrolled
in MR-CAS. Among the 128 subjects, 53 were symptomatic and 75 asymptomatic. The symptomatic
patients were classified into three groups based on interval from onset of symptoms
to the date of the carotid MRI (Group <14 days; 15-30 days; and > 30 days). The volume
of each plaque component was identified and quantified from MR images. The presence
of juxtaluminal loose matrix/inflammation (LM/I) was identified as a possible indicator
of inflammation on the luminal side. Plaque components were compared between groups
using the Wilcoxon rank-sum or the Chi-square test. Patient characteristics and carotid
plaque morphology were similar among all four groups. The median volume of LM/I in
Group >30 days was significantly lower than in other groups (0 mm3 vs 12.3 mm3 and
18.1 mm3; p = 0.003). In addition, the prevalence of juxtaluminal LM/I decreased over time (ptrend = 0.002).
There were no statistically significant differences in other plaque components between
the symptomatic groups. The volume of LM/I was significantly smaller in Group >30 days
and prevalence of juxtaluminal LM/I in the atherosclerotic carotid plaque was high
in the early stages after events. This suggests that carotid plaques undergo rapid
evolution after an acute cerebrovascular ischemic event.
Keywords
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Article info
Publication history
Published online: February 07, 2023
Accepted:
February 5,
2023
Received in revised form:
January 12,
2023
Received:
October 19,
2022
Identification
Copyright
© 2023 Published by Elsevier B.V.
