Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China.
Center for Brain Disorders Research, Capital Medical University and Beijing Institute of Brain Disorders, Beijing, China.
Angiology. 2022 Feb;73(2):104-111. doi: 10.1177/00033197211012531. Epub 2021 May 21.
We compared plaque characteristics between symptomatic and asymptomatic sides in patients with bilateral carotid vulnerable plaques using magnetic resonance imaging (MRI). Participants (n = 67; mean age: 65.8 ± 7.7 years, 61 males) with bilateral carotid vulnerable plaques were included. Vulnerable plaques were characterized by intraplaque hemorrhage (IPH), large lipid-rich necrotic core (LRNC), or fibrous cap rupture (FCR) on MRI. Symptomatic vulnerable plaques showed greater plaque burden, LRNC volume (median: 221.4 vs 134.8 mm, = .003), IPH volume (median: 32.2 vs 22.5 mm, = .030), maximum percentage (Max%) LRNC (median: 51.3% vs 41.8%, = .002), Max%IPH (median: 13.4% vs 9.5%, = .022), cumulative slices of LRNC (median: 10 vs 8, = .005), and more juxtaluminal IPH and/or thrombus (29.9% vs 6.0%, = .001) and FCR (37.3% vs 16.4%, = .007) than asymptomatic ones. After adjusting for plaque burden, differences in juxtaluminal IPH and/or thrombus (odds ratio [OR]: 5.49, 95% CI: 1.61-18.75, = .007) and FCR (OR: 2.90, 95% CI: 1.16-7.24, = .022) between bilateral sides remained statistically significant. For patients with bilateral carotid vulnerable plaques, symptomatic plaques had greater burden, more juxtaluminal IPH and/or thrombus, and FCR compared with asymptomatic ones. The differences in juxtaluminal IPH and/or thrombus and FCR between bilateral sides were independent of plaque burden.
我们使用磁共振成像（MRI）比较了双侧颈动脉易损斑块患者症状侧和无症状侧的斑块特征。纳入了 67 名（平均年龄：65.8 ± 7.7 岁，61 名男性）双侧颈动脉易损斑块患者。MRI 上易损斑块的特征为斑块内出血（IPH）、大脂质丰富的坏死核心（LRNC）或纤维帽破裂（FCR）。症状性易损斑块显示出更大的斑块负担、LRNC 体积（中位数：221.4 与 134.8mm， =.003）、IPH 体积（中位数：32.2 与 22.5mm， =.030）、最大百分比（Max%）LRNC（中位数：51.3%与 41.8%， =.002）、Max%IPH（中位数：13.4%与 9.5%， =.022）、LRNC 累积切片数（中位数：10 与 8， =.005），以及更多的管腔外 IPH 和/或血栓（29.9%与 6.0%， =.001）和 FCR（37.3%与 16.4%， =.007）。在校正斑块负担后，双侧管腔外 IPH 和/或血栓（比值比 [OR]：5.49，95%置信区间 [CI]：1.61-18.75， =.007）和 FCR（OR：2.90，95% CI：1.16-7.24， =.022）之间的差异仍然具有统计学意义。对于双侧颈动脉易损斑块患者，症状性斑块与无症状斑块相比，负担更大，管腔外 IPH 和/或血栓更多，FCR 更多。双侧管腔外 IPH 和/或血栓和 FCR 之间的差异独立于斑块负担。
