• Raf H M van Hoof, SchreuderFloris H B MFHBM, Patty Nelemans, TruijmanMartine T BMTB, Narender P van Orshoven, Tobien H Schreuder, Werner H Mess, Sylvia Heeneman, Robert J van Oostenbrugge, Joachim E Wildberger, and M Eline Kooi.
• Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
• Cerebrovasc. Dis. 2017 Jan 1; 44 (5-6): 297-303.

BackgroundPatients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis.MethodsA total of 87 symptomatic patients with a recent stroke (n = 35) or (ocular) TIA (n = 52) underwent carotid DCE-MRI examination. Plaque microvasculature was studied in the vessel wall and adventitia using DCE-MRI and the pharmacokinetic modeling parameter Ktrans. Statistical analysis was performed with logistic regression, correcting for associated clinical risk factors.ResultsThe 75th percentile adventitial (OR 1.97, 95% CI 1.18-3.29) Ktrans was significantly associated with a recent ischemic stroke compared to (ocular) TIA in multivariate analysis, while clinical risk factors were not significantly associated with the type of event.ConclusionsThis study indicates a positive association of leaky plaque microvasculature with a recent ischemic stroke compared to (ocular) TIA. Prospective longitudinal studies are needed to investigate whether Ktrans or other plaque characteristics may serve as an imaging marker for predicting (the type of) future cerebrovascular events.© 2017 The Author(s) Published by S. Karger AG, Basel.

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