Ischemic Stroke Patients Demonstrate Increased Carotid Plaque Microvasculature Compared to (Ocular) Transient Ischemic Attack Patients.
BACKGROUND
Patients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis.


METHODS
A total of 87 symptomatic patients with a recent stroke (n = 35) or (ocular) TIA (n = 52) underwent carotid DCE-MRI examination. Plaque microvasculature was studied in the vessel wall and adventitia using DCE-MRI and the pharmacokinetic modeling parameter Ktrans. Statistical analysis was performed with logistic regression, correcting for associated clinical risk factors.


RESULTS
The 75th percentile adventitial (OR 1.97, 95% CI 1.18-3.29) Ktrans was significantly associated with a recent ischemic stroke compared to (ocular) TIA in multivariate analysis, while clinical risk factors were not significantly associated with the type of event.


CONCLUSIONS
This study indicates a positive association of leaky plaque microvasculature with a recent ischemic stroke compared to (ocular) TIA. Prospective longitudinal studies are needed to investigate whether Ktrans or other plaque characteristics may serve as an imaging marker for predicting (the type of) future cerebrovascular events.
['van Hoof|Raf H M|RHM|', 'Schreuder|Floris H B M|FHBM|', 'Nelemans|Patty|P|', 'Truijman|Martine T B|MTB|', 'van Orshoven|Narender P|NP|', 'Schreuder|Tobien H|TH|', 'Mess|Werner H|WH|', 'Heeneman|Sylvia|S|', 'van Oostenbrugge|Robert J|RJ|', 'Wildberger|Joachim E|JE|', 'Kooi|M Eline|ME|']
D000368:Aged D002545:Brain Ischemia D002199:Capillary Permeability D002339:Carotid Arteries D016893:Carotid Stenosis D003287:Contrast Media D003430:Cross-Sectional Studies D005260:Female D006801:Humans D002546:Ischemic Attack, Transient D008279:Magnetic Resonance Imaging D008297:Male D055806:Microvessels D008875:Middle Aged D009942:Organometallic Compounds D058226:Plaque, Atherosclerotic D011237:Predictive Value of Tests D011379:Prognosis D012720:Severity of Illness Index D020521:Stroke
Ischemic stroke Microvasculature Transient ischemic attack Dynamic contrast-enhanced MRI Atherosclerosis Magnetic resonance imaging