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The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis
OBJECTIVE: Carotid intraplaque hemorrhage (IPH) is a well-known risk indicator of thromboembolism, but it is not easy to rapidly detect IPH in acute symptomatic carotid disease. The aim of this study was to assess the utility of time-of-flight (TOF) magnetic resonance angiography (MRA) in the detect...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018040/ https://www.ncbi.nlm.nih.gov/pubmed/32053703 http://dx.doi.org/10.1371/journal.pone.0229024 |
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author | Gwak, Dong-Seok Kim, Baik-Kyun Chung, Inyoung Han, Moon-Ku |
author_facet | Gwak, Dong-Seok Kim, Baik-Kyun Chung, Inyoung Han, Moon-Ku |
author_sort | Gwak, Dong-Seok |
collection | PubMed |
description | OBJECTIVE: Carotid intraplaque hemorrhage (IPH) is a well-known risk indicator of thromboembolism, but it is not easy to rapidly detect IPH in acute symptomatic carotid disease. The aim of this study was to assess the utility of time-of-flight (TOF) magnetic resonance angiography (MRA) in the detection of IPH and evaluate the degree of stenosis and stroke patterns in patients with acute symptomatic carotid disease. METHODS: We retrospectively identified consecutive patients with acute symptomatic carotid disease who were admitted within 12 h after stroke onset. Fifty-nine patients underwent TOF MRA at admission and were categorized according to the presence or absence of intraplaque high signal intensity (HSI). The severity of carotid stenosis and diffusion-weighted magnetic resonance imaging lesion patterns were evaluated. RESULTS: Intraplaque HSI was detected in 28.8% of the enrolled patients (17/59). Mild-to-moderate symptomatic carotid stenosis was more frequent in the intraplaque HSI-positive group (70.6%) than in the intraplaque HSI-negative group (42.8%) (p = 0.015). The patients with intraplaque HSI more frequently exhibited a disseminated small infarction pattern (76.5% in the intraplaque HSI-positive group, 47.6% in the -negative group), and did not exhibit a border-zone infarction pattern (0% in the positive group, 16.7% in the negative group). CONCLUSIONS: TOF MRA may be a useful noninvasive and rapid tool to detect IPH in patients with acute symptomatic carotid disease. IPH was common in those with a lower degree of carotid stenosis and manifested as a disseminated small infarction pattern. Intraplaque HSI on TOF MRA in acute symptomatic carotid disease may help to determine the mechanism of stroke and establish early treatment plans. |
format | Online Article Text |
id | pubmed-7018040 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-70180402020-02-26 The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis Gwak, Dong-Seok Kim, Baik-Kyun Chung, Inyoung Han, Moon-Ku PLoS One Research Article OBJECTIVE: Carotid intraplaque hemorrhage (IPH) is a well-known risk indicator of thromboembolism, but it is not easy to rapidly detect IPH in acute symptomatic carotid disease. The aim of this study was to assess the utility of time-of-flight (TOF) magnetic resonance angiography (MRA) in the detection of IPH and evaluate the degree of stenosis and stroke patterns in patients with acute symptomatic carotid disease. METHODS: We retrospectively identified consecutive patients with acute symptomatic carotid disease who were admitted within 12 h after stroke onset. Fifty-nine patients underwent TOF MRA at admission and were categorized according to the presence or absence of intraplaque high signal intensity (HSI). The severity of carotid stenosis and diffusion-weighted magnetic resonance imaging lesion patterns were evaluated. RESULTS: Intraplaque HSI was detected in 28.8% of the enrolled patients (17/59). Mild-to-moderate symptomatic carotid stenosis was more frequent in the intraplaque HSI-positive group (70.6%) than in the intraplaque HSI-negative group (42.8%) (p = 0.015). The patients with intraplaque HSI more frequently exhibited a disseminated small infarction pattern (76.5% in the intraplaque HSI-positive group, 47.6% in the -negative group), and did not exhibit a border-zone infarction pattern (0% in the positive group, 16.7% in the negative group). CONCLUSIONS: TOF MRA may be a useful noninvasive and rapid tool to detect IPH in patients with acute symptomatic carotid disease. IPH was common in those with a lower degree of carotid stenosis and manifested as a disseminated small infarction pattern. Intraplaque HSI on TOF MRA in acute symptomatic carotid disease may help to determine the mechanism of stroke and establish early treatment plans. Public Library of Science 2020-02-13 /pmc/articles/PMC7018040/ /pubmed/32053703 http://dx.doi.org/10.1371/journal.pone.0229024 Text en © 2020 Gwak et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Gwak, Dong-Seok Kim, Baik-Kyun Chung, Inyoung Han, Moon-Ku The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title | The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title_full | The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title_fullStr | The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title_full_unstemmed | The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title_short | The usefulness of Time-of-Flight MR angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
title_sort | usefulness of time-of-flight mr angiography in detection of intraplaque hemorrhage in patients with acute ischemic stroke with symptomatic carotid stenosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018040/ https://www.ncbi.nlm.nih.gov/pubmed/32053703 http://dx.doi.org/10.1371/journal.pone.0229024 |
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