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

J Comput Assist Tomogr

From the *Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; †Unità Operativa di Radiologia Diagnostica e Interventistica, Azienda Ospedaliera San Paolo, Milan, Italy; ‡Vascular Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; and §Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, San Donato Milanese, Italy.

Published: April 2017

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.

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http://dx.doi.org/10.1097/RCT.0000000000000506DOI Listing

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