MRI of carotid atherosclerotid plaques

Transcription

1 MRI of carotid atherosclerotid plaques Poster No.: C-0208 Congress: ECR 2015 Type: Scientific Exhibit Authors: N. Ananyeva, T. Rostovtseva, R. Ezhova, O. Zheleznyakova, K. Laptev; Saint-Petersburg/RU Keywords: DOI: Vascular, Arteries / Aorta, MR, MR-Angiography, Imaging sequences, Arteriosclerosis /ecr2015/C-0208 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 5

2 Aims and objectives to study possibilities of MRI in the assesment of atherosclerotic plaque structure in patients with atherosclerotic disease of carotid arteries. Methods and materials 14 patients (3 men and 11 women) in the age from 52 to 84 years underwent MRI of carotid arteries. All of the patients previously underwent ultrasound examination of carotid arteries, 2 of them- CT angiography and 2- traditional digital subtractional angiography. All of the patients had atherosclerotic plaques with stenosis from 17 to 70%, in 6 patients plaques were bilateral. For MRI we used 1,5 T Exelart Vantage Toshiba Scanner with neurovascular coil. Field of interest included 2cm. proximal and distal to the common carotid artery bifurcation. Scan thickness was 3mm., mean scanning time was 26,5 minutes. No contrast enchancement was used. Scanning protocol included PPG (peripheral pulse gating) -bright blood sequence for the assesment of stenosis, plaque fibrous cap intactness and for the assesement of calcified lesions. We also used black blood sequenses: T1, T2, PD, intermediate weighted images (IMW) for the visualization of vessel wall and for the identification of main plaque components (lipid core, hemorrhage, fibrosis). We considered calcified lesions that were hypointense on every sequense (including PPG). Lipid core was hyperintense on T1, and variable on T2 and PD. Fibrous was mostly slightly hyperintense on T1, T2 and PD. Results Thin fibrous cap was found in 1 case, rich lipid necrotic core- in 7 patients, calcified plaques were found in 11 patients (agreed with CT). Two patients underwent carotid plaque endarterectomy with following patho-morphological examination: in both cases plaque components found by MRI corresponded to pathomorphology. In one patient MRI excluded CCA oclusion, suspected on ultrasound examination. Images for this section: Page 2 of 5

3 Fig. 1: Atherosclerotic plaque of left ICA (AHA type IV-V: rich lipid necrotic core, intact thick fibrous cap) Fig. 2: Atherosclerotic plaque of right ICA (AHA type VI: rich lipid necrotic core, calcification, thin fibrous cap with possible defect) Fig. 3: Calcified atherosclerotic plaque of left ICA (AHA type VII) Page 3 of 5

4 Conclusion Early diagnosis of atherosclerosis is important for the opportune life style and pharmacological correction in order to avoid disease progression. In patients with established carotid atherosclerosis it is crucial to identify unstable plaques. MRI has greate potential in detecting and evaluation main plaque components and unstability patterns and revealing patients with moderate stenosis but high risk of plaque rupture. Personal information Saint-Petersburg Psychoneurological Research Institute , 3, Bekhtereva str., Saint-Petersburg, Russia. Mariinskaya Municipal Hospital Department of cardiovascular surgery , 56, Liteyny pr., Saint-Petersburg, Russia. References 1.Saam T, Hatsukami TS, Takaya N, et al. The Vul- nerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment. Radiology 2007; 244: Strazden E.YU.1, Shariya M.A.1,2, Tararak E.M.1, Ustyuzhanin D.V.1. #pplication of magnetic resonance imaging in determining of Page 4 of 5

5 atherosclerotic plaque stability. Russian Electronic journal of radiology. Vol.3; #1; 2013; P Underhill HR, Yuan C, Yamykh VL, Chu B, Oikawa M, Dong L, Polissar NL, Garden GA, Cramer SC, Hatsukami TS: Preditors of surface disruption with MR imaging in asymptomatic carotid artery stenosis. AJNR Am Neuroradiol 2010, 31: Zavodni A.E., Wasserman B.A., McCleland R.L., Gomes A.S., Folsom A.R., Polak J.F., Lima J.A., Bluemke D.A. / Carotid Artery Plaque Morphology and Composition in Relation to Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA) / Radiology, 2014 Feb26; Page 5 of 5