Mariana Selwaness MD, Presenter: Nothing to Disclose

Reinhard Hameeteman MSC, Abstract Co-Author: Nothing to Disclose

Oscar H. Franco, Abstract Co-Author: Nothing to Disclose

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

Jolanda J. Wentzel PhD, Abstract Co-Author: Nothing to Disclose

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

The extent of carotid atherosclerosis is considered a potentially relevant risk marker for stroke. In a large stroke-free population, we identified cardiovascular risk factors and carotid plaque components associated with carotid plaque burden and lumen volume.

Within The Rotterdam Study, we performed prescreening of carotid arteries with ultrasound to select participants with carotid plaques ≥2.5 cm. On 1.5-Tesla carotid MRI scanning, plaque composition and luminal stenosis were visually assessed. Inner and outer wall of the carotid arteries were bilaterally segmented using a validated automated method in order to measure plaque burden. We analyzed sex-specific standardized relations of cardiovascular and imaging risk factors to plaque burden and lumen volumes using regression analysis.

In 1562 participants (mean age 72.7±9.2 years, 46% women), we automatically segmented 2821 carotid atherosclerotic plaques. Women had larger plaque burden (50.7±7.8% vs. 49.2±7.7%, p<0.001) and smaller lumen volumes (933±286 mm3 vs. 1078±334 mm3, p<0.001) than men. In women, age, HDL-levels and systolic blood pressure, and in men, cholesterol levels and statin use were independently and significantly associated with plaque burden and lumen volume. Furthermore, smoking and DM related to lumen volume in men (p<0.05). Intraplaque hemorrhage is an additional risk factor for plaque burden (OR 1.28; 95%CI 1.03-1.58). Finally, within the highest quartile of plaque burden, IPH was strongly associated with stenosis independent of age, sex, plaque burden and composition (OR 15.2; 95%CI 11.8-18.6).

Several cardiovascular risk factors as well as plaque composition, in particular IPH, are associated with plaque burden. Carotid IPH is a strong risk factor for luminal stenosis.

Carotid plaque burden could play a role as a promising biomarker for cardiovascular disease. MRI-based automated segmentation is a user-friendly and non-invasive tool that may serve to identify risk factors of plaque burden in population studies.

Selwaness, M, Hameeteman, R, Franco, O, Van Der Lugt, A, Wentzel, J, Vernooij, M, A Population-based Study on MRI-based Automated Segmentation of Carotid Atherosclerotic Plaque Burden.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019497.html