Quirijn van den Bouwhuijsen, Presenter: Nothing to Disclose

Meike Willemijn Vernooij MD, Abstract Co-Author: Nothing to Disclose

Gabriel P. Krestin MD, PhD, Abstract Co-Author: Consultant, General Electric Company Research grant, General Electric Company Research grant, Bayer AG Research grant, Siemens AG

Wiro Niessen PhD, Abstract Co-Author: Nothing to Disclose

Mohammad Arfan Ikram, Abstract Co-Author: Nothing to Disclose

Jacqueline C.m. Witteman PhD, Abstract Co-Author: Nothing to Disclose

Aad Van Der Lugt MD, PhD, Abstract Co-Author: Nothing to Disclose

Vulnerable plaque components in carotid arteries can be detected non-invasively with magnetic resonance imaging (MRI). In asymptomatic persons, the relation between carotid plaque composition and vascular brain disease is not well studied. We studied the association between carotid atherosclerotic plaque characteristics and ischemic brain disease on MRI.

From the population-based Rotterdam Study, 952 participants with carotid wall thickening on ultrasound >2.5 mm underwent both carotid MRI and brain MRI. Maximum carotid wall thickening, degree of stenosis and presence of intraplaque hemorrhage, lipid core and calcification were assessed in both carotid arteries. Associations between plaque characteristics and white matter lesions (WMLs), lacunar and cortical infarcts were investigated per participant and additionally per carotid artery. Analysis were adjusted for cardiovascular risk factors.

Carotid stenosis (OR per 10% stenosis increase 1.2 95% confidence interval (1.0-1.4), maximum carotid wall thickness (per mm increase 1.3,1.1-1.6) en presence of intraplaque hemorrhage (1.9,1.1-3.3), were all found to be significantly associated with presence of cortical infarcts, both in the participant based analysis and in the carotid artery based analysis. There were no associations between any plaque characteristics and presence of lacunar infarcts. In the subject based analysis maximum plaque thickness, presence of intraplaque hemorrhage and calcification were associated with WML-volume. In the artery based analysis only the association for calcifications remained.

Presence of carotid intraplaque hemorrhage and measures of carotid plaque size are independently associated with cortical infarcts, but not with lacunar infarcts. Plaque calcification, but not vulnerable plaque components, is related to WML volume.

This MRI study gives insight into the importance of atherosclerotic plaque composition, also in small plaques, for development of ischemic brain disease.

Bouwhuijsen, Q, Vernooij, M, Krestin, G, Niessen, W, Ikram, M, Witteman, J, Van Der Lugt, A, Carotid Plaque Morphology and Ischemic Vascular Brain Disease on MRI.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009952.html