de Havenon Adam, Tirschwell David, Majersik Jennifer J, McNally Scott, Stoddard Gregory, Moore Anne, Mossa-Basha Mahmud
1 University of Utah Department of Neurology, USA.
2 University of Washington Department of Neurology, USA.
Neuroradiol J. 2017 Oct;30(5):486-489. doi: 10.1177/1971400917707351. Epub 2017 Jun 20.
Background Carotid intraplaque hemorrhage (IPH) seen on vessel wall MRI is associated with an increased risk of stroke or transient ischemic attack, as are microembolic signals (MES) detected by transcranial Doppler (TCD). We sought to examine the association between IPH and MES in acute stroke patients with symptomatic carotid atherosclerosis. Methods Through a retrospective chart review, we included patients from 2011 to 2013 with acute ischemic stroke due to carotid atherosclerosis of varying stenosis who had both 3D volumetric MRI of the neck and TCD emboli monitoring. Results Twenty-four patients met the inclusion criteria. Mean time from stroke to MRI was 1.4 ± 1.9 days and to TCD was 2.6 ± 2.4 days. MES was seen in 10 patients (42%) and IPH was present in seven patients (29%), but we did not find a relationship between MES and IPH ( p = 0.64). Conclusion In patients with recent acute ischemic stroke attributed to carotid atherosclerosis, we did not detect an association between the presence of IPH and MES. While this small study may be underpowered, an alternate explanation is that MES and IPH reflect vulnerable carotid atherosclerosis through different mechanisms. This untested concept warrants prospective study in a larger cohort.
血管壁磁共振成像（MRI）显示的颈动脉斑块内出血（IPH）与中风或短暂性脑缺血发作风险增加相关，经颅多普勒（TCD）检测到的微栓塞信号（MES）也是如此。我们试图研究有症状颈动脉粥样硬化急性中风患者中IPH与MES之间的关联。方法：通过回顾性病历审查，我们纳入了2011年至2013年因不同狭窄程度的颈动脉粥样硬化导致急性缺血性中风且同时进行了颈部三维容积MRI和TCD栓子监测的患者。结果：24例患者符合纳入标准。从中风到MRI的平均时间为1.4±1.9天，到TCD的平均时间为2.6±2.4天。10例患者（42%）出现MES，7例患者（29%）存在IPH，但我们未发现MES与IPH之间存在关联（p = 0.64）。结论：在近期因颈动脉粥样硬化导致急性缺血性中风的患者中，我们未检测到IPH与MES之间存在关联。虽然这项小型研究可能效力不足，但另一种解释是，MES和IPH通过不同机制反映易损颈动脉粥样硬化。这一未经检验的概念值得在更大队列中进行前瞻性研究。
