Is Carotid Plaque Contrast Enhancement on MRI Predictive for Cerebral or Cardiovascular Events? A Prospective Cohort Study

J Comput Assist Tomogr. 2017 Mar/Apr;41(2):321-326. doi: 10.1097/RCT.0000000000000506.

Abstract

Objective: The aim of this study was to correlate carotid plaque contrast enhancement (CPCE) to onset of cerebral/cardiovascular events (CCVE) in patients with atherosclerotic carotid disease.

Methods: The ethics committee approved this prospective study. Patients with carotid artery stenosis underwent magnetic resonance angiography before/after injection of 0.1 mmol/kg of gadobenate dimeglumine. Carotid plaque contrast enhancement was graded as follows: 0, no CPCE; 1, 1 single enhancement focus; 2, 2 or more foci.

Results: Seventy-seven patients (71 ± 9 years) had a stenosis degree: 34 mild, 16 moderate, 27 severe at the right side, and 36, 15, and 25 at the left side. Carotid plaque contrast enhancement was 0 in 30 patients, 1 in 26, 2 in 11 at the right, and 37, 19, and 13 at the left. Forty-seven CCVE occurred after magnetic resonance imaging, correlated to both stenosis degree (P = 0.006) and CPCE (P = 0.032). Excluding surgery/stenting, the correlation held only for CPCE (P = 0.017). Of 49 patients showing CPCE, 5 (10%) reported CCVE; of 21 patients without CPCE, none reported CCVE (P = 0.129).

Conclusions: The absence of CPCE seems to be a negative predictor for CCVE.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications*
  • Brain Ischemia / diagnostic imaging
  • Carotid Arteries / diagnostic imaging
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging*
  • Cohort Studies
  • Contrast Media*
  • Female
  • Humans
  • Image Enhancement / methods*
  • Magnetic Resonance Angiography / methods*
  • Male
  • Meglumine / analogs & derivatives
  • Middle Aged
  • Myocardial Ischemia / complications*
  • Myocardial Ischemia / diagnostic imaging
  • Organometallic Compounds
  • Plaque, Atherosclerotic / complications
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Predictive Value of Tests
  • Prospective Studies

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine