Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
PLoS One. 2012;7(7):e42472. doi: 10.1371/journal.pone.0042472. Epub 2012 Jul 31.
To investigate the natural history of carotid atherosclerosis in patients who experienced a TIA or ischemic stroke.
Ninety-two TIA/stroke patients (57 men, mean age 67.7 ± 9.8 years) with ipsilateral <70% carotid stenosis underwent multisequence MRI of the plaque ipsilateral to the symptomatic side at baseline and after one year. For each plaque, several parameters were assessed at both time points.
Carotid lumen, wall and total vessel ( = carotid lumen and wall) volume did not significantly change. Forty-four patients had a plaque with a lipid-rich necrotic core (LRNC) at baseline, of which 34 also had a LRNC after one year. In three patients a LRNC appeared after one year. Thirty patients had a plaque with a thin and/or ruptured fibrous cap (FC) at both time points. In seven patients, FC status changed from thin and/or ruptured into thick and intact. In three patients, FC status changed from thick and intact into thin and/or ruptured. Twenty patients had intraplaque hemorrhage (IPH) at both time points. In four patients, IPH disappeared, whereas in three patients, new IPH appeared at follow-up.
In TIA/stroke patients, carotid plaque morphology does not significantly change over a one-year period. IPH and FC status change in a minority of patients.
研究短暂性脑缺血发作（TIA）或缺血性脑卒中患者颈动脉粥样硬化的自然史。
92 例 TIA/脑卒中患者（57 例男性，平均年龄 67.7±9.8 岁），同侧颈动脉狭窄<70%，在基线和 1 年后对症状侧同侧斑块进行多序列 MRI 检查。在两个时间点，对每个斑块的多个参数进行评估。
颈动脉管腔、管壁和总血管（=颈动脉管腔和管壁）体积无明显变化。44 例患者在基线时存在富含脂质的坏死核心（LRNC）斑块，其中 34 例在 1 年后也存在 LRNC。3 例患者在 1 年后出现了 LRNC。30 例患者在两个时间点均存在薄而/或破裂的纤维帽（FC）斑块。在 7 例患者中，FC 状态由薄而/或破裂转变为厚而完整。在 3 例患者中，FC 状态由厚而完整转变为薄而/或破裂。20 例患者在两个时间点均存在斑块内出血（IPH）。4 例患者的 IPH 消失，而 3 例患者在随访时出现新的 IPH。
在 TIA/脑卒中患者中，颈动脉斑块形态在 1 年内无明显变化。少数患者的 IPH 和 FC 状态发生变化。
