Asymptomatic carotid artery plaques: use of magnetic resonance imaging to characterize vulnerable plaques in 6 cases

Background: Echography is a convenient and noninvasive method of characterizing carotid artery plaques. However, recent reports suggest that multisequential MR imaging may yield better data regarding the instability of asymptomatic carotid artery plaques. 'Therefore, the goal of the present study was to show the useful information for asymptomatic carotid artery plaque. Methods: A total of 6 patients (5 men, I woman; age range, 62-76 years; mean age, 69.2 years) with carotid artery plaques, which were detected during medical check-up using carotid MR angiography and/or echography, underwent MR imaging. Two-dimensional TOF MR angiography, T1WI, and fat-suppressed, cardiac-gated, black-blood proton density image, and T2WI were obtained with a 1.5-T MR imager. All plaques underwent carotid endarterectomy and histological examination. Results: The MR imaging demonstrated high signals in at least one modality in 4 of 7 plaques. In the remaining 3 patients, MR imaging detected partial-high signals, which corresponded to histologically confirmed partial lipid core or hemorrhagic components in the fibrous tissues The TOF MR imaging showed 2 cases of thin fibrous caps, and MR imaging also showed a. large mural thrombus in I patient. Conclusions: Magnetic resonance imaging was useful in characterizing factors associated with plaque instability in patients with asymptomatic carotid artery plaques and may help guide therapeutic strategies for asymptomatic carotid artery plaques. (c) 2007 Elsevier Inc. All rights reserved.