Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Carotid Artery MRI helps predict likelihood of strokes and heart attacks

04.03.2014

Noninvasive imaging of carotid artery plaque with MRI can accurately predict future cardiovascular events like strokes and heart attacks in people without a history of cardiovascular disease, according to a new study published online in the journal Radiology.

Researchers have long known that some arterial plaque is more dangerous because of its vulnerability to rupture. MRI can discern features of vulnerable plaque, such as a lipid core with a thin fibrous cap. This ability makes MRI a potentially valuable tool for identifying patients at risk for subsequent cardiovascular events.

Transverse Gadolinium-enhanced T1-weighted MR

This shows transverse gadolinium-enhanced T1-weighted MR images obtained superior to the carotid artery bifurcation in a 72-year-old man. L = ICA lumen. (a) Low-signal-intensity calcium (arrow) and lipid core (arrowheads) can be seen. (b) Note contouring of the ICA. The outer adventitial wall (red), lipid core (blue), calcification (green), and vessel lumen (purple) are visible.

Credit: Radiological Society of North America

To study the predictive value of MRI plaque imaging, researchers performed carotid artery ultrasound and MRI on 946 asymptomatic patients from the Multi-Ethnic Study of Atherosclerosis (MESA). The carotid arteries are the large vessels located on each side of the neck that carry oxygenated blood to the front part of the brain. They are highly accessible for imaging, and their condition tends to mirror that of the coronary arteries that supply the heart with oxygenated blood.

The researchers used ultrasound to assess carotid wall thickness and MRI to define carotid plaque composition and the remodeling index, a measure of changes in vessel size. Imaging results were compared with cardiovascular events, including heart attacks, stroke and death, for an average of 5.5 years after examination.

"We studied asymptomatic individuals with a low risk of cardiovascular events at baseline and used noninvasive imaging to predict the risk of an event downstream," said David A. Bluemke, M.D, Ph.D., from the National Institutes of Health Clinical Center in Bethesda, Md. "This is the first population-based prospective study to determine if vulnerable plaque features by MRI add to the risk of a cardiovascular event beyond the traditional risk factors."

Cardiovascular events occurred in 59 of the patients. Abnormal thickening of the carotid artery wall and the presence of a lipid core and calcium in the internal carotid artery on MRI were significant predictors of subsequent events. A lipid core was present in almost half of the patients who had an event, compared with only 17.8 percent of those who did not have an event.

"The primary factors that predicted future risk were measures of vessel wall thickness in combination with the presence or absence of a lipid core," Dr. Bluemke said. "The presence of a lipid core was 50 percent more common in people who had subsequent events."

Use of MRI improved the reclassification of baseline cardiovascular risk in the study group. When both the carotid remodeling index and lipid core were used for risk stratification, approximately 16 percent more patients with events and 7 percent without events were correctly reclassified compared with the use of traditional risk factors.

"The results bolster the use of MRI as a surrogate marker of efficacy in therapeutic studies and point to a role in determining which patients might need more aggressive treatments," Dr. Bluemke said. "As risk factor prediction gets better, we'll be able to screen more intelligently and use more intensive treatments in those individuals who face a higher risk of cardiovascular events."

Dr. Bluemke noted that sequences for plaque composition could be readily added to existing carotid MRI angiography protocols for clinical purposes.

"Carotid MRI has significant advantages," he said. "The results are more reproducible than those of ultrasound."

Availability and cost effectiveness could limit the use of MRI, Dr. Bluemke cautioned. However, ultrasound and computed tomography (CT) are viable alternatives for screening, he said, especially with improvements in CT dose reduction.

###

"Carotid Artery Plaque Morphology and Composition in Relation to Incident Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis (MESA)." Collaborating with Dr. Bluemke were Anna E. H. Zavodni, M.D., Bruce A. Wasserman, M.D., Robyn L. McClelland, Ph.D., Antoinette S. Gomes, M.D., Aaron R. Folsom, M.D., M.P.H., Joseph F. Polak, M.D., M.P.H., and João A. C. Lima, M.D.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill.

For patient-friendly information on MRI, visit RadiologyInfo.org.

Linda Brooks | EurekAlert!

Further reports about: MRI atherosclerosis coronary arteries heart attacks

More articles from Medical Engineering:

nachricht A non-invasive tool for diagnosing cancer*
21.05.2015 | The Agency for Science, Technology and Research (A*STAR)

nachricht PolyU develops novel computer intelligence system for acute stroke detection
20.05.2015 | The Hong Kong Polytechnic University

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Advance in regenerative medicine

The only professorship in Germany to date, one master's programme, one laboratory with worldwide unique equipment and the corresponding research results: The University of Würzburg is leading in the field of biofabrication.

Paul Dalton is presently the only professor of biofabrication in Germany. About a year ago, the Australian researcher relocated to the Würzburg department for...

Im Focus: Basel Physicists Develop Efficient Method of Signal Transmission from Nanocomponents

Physicists have developed an innovative method that could enable the efficient use of nanocomponents in electronic circuits. To achieve this, they have developed a layout in which a nanocomponent is connected to two electrical conductors, which uncouple the electrical signal in a highly efficient manner. The scientists at the Department of Physics and the Swiss Nanoscience Institute at the University of Basel have published their results in the scientific journal “Nature Communications” together with their colleagues from ETH Zurich.

Electronic components are becoming smaller and smaller. Components measuring just a few nanometers – the size of around ten atoms – are already being produced...

Im Focus: IoT-based Advanced Automobile Parking Navigation System

Development and implementation of an advanced automobile parking navigation platform for parking services

To fulfill the requirements of the industry, PolyU researchers developed the Advanced Automobile Parking Navigation Platform, which includes smart devices,...

Im Focus: First electrical car ferry in the world in operation in Norway now

  • Siemens delivers electric propulsion system and charging stations with lithium-ion batteries charged from hydro power
  • Ferry only uses 150 kilowatt hours (kWh) per route and reduces cost of fuel by 60 percent
  • Milestone on the road to operating emission-free ferries

The world's first electrical car and passenger ferry powered by batteries has entered service in Norway. The ferry only uses 150 kWh per route, which...

Im Focus: Into the ice – RV Polarstern opens the arctic season by setting course for Spitsbergen

On Tuesday, 19 May 2015 the research icebreaker Polarstern will leave its home port in Bremerhaven, setting a course for the Arctic. Led by Dr Ilka Peeken from the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI) a team of 53 researchers from 11 countries will investigate the effects of climate change in the Arctic, from the surface ice floes down to the seafloor.

RV Polarstern will enter the sea-ice zone north of Spitsbergen. Covering two shallow regions on their way to deeper waters, the scientists on board will focus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International symposium: trends in spatial analysis and modelling for a more sustainable land use

20.05.2015 | Event News

15th conference of the International Association of Colloid and Interface Scientists

18.05.2015 | Event News

EHFG 2015: Securing health in Europe. Balancing priorities, sharing responsibilities

12.05.2015 | Event News

 
Latest News

A chip placed under the skin for more precise medicine

27.05.2015 | Health and Medicine

Linking superconductivity and structure

27.05.2015 | Physics and Astronomy

Mental health care access for teens improving, but less for communities with disparities

27.05.2015 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>