Keisuke Morihara1,2, Tatsu Nakano1, Kentaro Mori3, Issei Fukui3, Motohiro Nomura3, Keiichiro Suzuki4, Kenichi Hirano4, Mitsuyuki Takahashi4, Hideyuki Takeuchi2, Hiroshi Doi2, Yoshihisa Kitamura3, Fumiaki Tanaka5. 1. Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan. 2. Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 3. Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan. 4. Department of Radiology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan. 5. Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan. ftanaka@yokohama-cu.ac.jp.
Abstract
PURPOSE: Recently, various magnetic resonance imaging (MRI) modalities have been developed to easily detect carotid and aortic plaques, but these techniques are time-consuming and vulnerable to motion artifacts. We investigated the utility of a gradient echo MRI technique known as liver acquisition with volume acceleration flexible (LAVA-Flex) to detect carotid and aortic atherosclerotic plaques. METHODS: Ten patients who underwent carotid endarterectomy (CEA) were assessed regarding the correspondence between LAVA-Flex findings and the histopathology of excised carotid plaques. In addition, 47 patients with cryptogenic ischemic stroke underwent LAVA-Flex and transesophageal echocardiography (TEE) for detection of embolic sources in the thoracic aorta. We analyzed the relationship between the thickness of the aortic plaque measured by TEE and the presence of high-intensity lesions on LAVA-Flex. RESULTS: Nine of 10 patients (90.0%) who underwent CEA showed a high-intensity carotid lesion on LAVA-Flex, which corresponded pathologically to plaques containing large lipid cores and hemorrhage. Twenty-four (51.1%) of 47 cryptogenic stroke patients showed a high-intensity lesion in the thoracic aorta on LAVA-Flex; of these, 21 (87.5%) also demonstrated a large plaque (thickness ≥4 mm) on TEE. Twenty-two (95.7%) of 23 patients without a high-intensity lesion on LAVA-Flex demonstrated no large plaque on TEE. LAVA-Flex had a sensitivity of 95.5% and a specificity of 88.0% in patients with large plaques. CONCLUSION: This study showed that LAVA-Flex successfully detected carotid and aortic plaques. This imaging technique may be useful to rapidly diagnose and evaluate carotid and aortic plaques, which are critical risk factors for aortogenic stroke.
PURPOSE: Recently, various magnetic resonance imaging (MRI) modalities have been developed to easily detect carotid and aortic plaques, but these techniques are time-consuming and vulnerable to motion artifacts. We investigated the utility of a gradient echo MRI technique known as liver acquisition with volume acceleration flexible (LAVA-Flex) to detect carotid and aortic atherosclerotic plaques. METHODS: Ten patients who underwent carotid endarterectomy (CEA) were assessed regarding the correspondence between LAVA-Flex findings and the histopathology of excised carotid plaques. In addition, 47 patients with cryptogenic ischemic stroke underwent LAVA-Flex and transesophageal echocardiography (TEE) for detection of embolic sources in the thoracic aorta. We analyzed the relationship between the thickness of the aortic plaque measured by TEE and the presence of high-intensity lesions on LAVA-Flex. RESULTS: Nine of 10 patients (90.0%) who underwent CEA showed a high-intensity carotid lesion on LAVA-Flex, which corresponded pathologically to plaques containing large lipid cores and hemorrhage. Twenty-four (51.1%) of 47 cryptogenic stroke patients showed a high-intensity lesion in the thoracic aorta on LAVA-Flex; of these, 21 (87.5%) also demonstrated a large plaque (thickness ≥4 mm) on TEE. Twenty-two (95.7%) of 23 patients without a high-intensity lesion on LAVA-Flex demonstrated no large plaque on TEE. LAVA-Flex had a sensitivity of 95.5% and a specificity of 88.0% in patients with large plaques. CONCLUSION: This study showed that LAVA-Flex successfully detected carotid and aortic plaques. This imaging technique may be useful to rapidly diagnose and evaluate carotid and aortic plaques, which are critical risk factors for aortogenic stroke.
Authors: Z A Fayad; T Nahar; J T Fallon; M Goldman; J G Aguinaldo; J J Badimon; M Shinnar; J H Chesebro; V Fuster Journal: Circulation Date: 2000-05-30 Impact factor: 29.690
Authors: Denise P Hinton; Ricardo C Cury; Raymond C Chan; Lawrence L Wald; Jane B Sherwood; Karen L Furie; John T Pitts; Franz Schmitt Journal: Eur J Radiol Date: 2006-01-26 Impact factor: 3.528
Authors: Noriko Oyama; Philimon Gona; Carol J Salton; Michael L Chuang; Rahul R Jhaveri; Susan J Blease; Anya R Manning; Marc Lahiri; René M Botnar; Daniel Levy; Martin G Larson; Christopher J O'Donnell; Warren J Manning Journal: Arterioscler Thromb Vasc Biol Date: 2007-11-08 Impact factor: 8.311
Authors: Anouk L M Eikendal; Björn A Blomberg; Cees Haaring; Tobias Saam; Rob J van der Geest; Fredy Visser; Michiel L Bots; Hester M den Ruijter; Imo E Hoefer; Tim Leiner Journal: J Cardiovasc Magn Reson Date: 2016-04-14 Impact factor: 5.364
Authors: Yu Sakai; Vance T Lehman; Laura B Eisenmenger; Emmanuel C Obusez; G Abbas Kharal; Jiayu Xiao; Grace J Wang; Zhaoyang Fan; Brett L Cucchiara; Jae W Song Journal: Front Neurol Date: 2022-07-28 Impact factor: 4.086