Associations Between Carotid Plaque Characteristics and Improvement of Cerebral Blood Perfusion in Patients With Moderate to Severe Carotid Stenosis Undergoing Carotid Endarterectomy

作者：Ran Huo, Huimin Xu, Dandan Yang, Huiyu Qiao, Jin Li, Hualu Han, Ying Liu, Tao Wang, Huishu Yuan, Xihai Zhao · 发表于：Journal of Magnetic Resonance Imaging · 年份：2020 · DOI：10.1002/jmri.27365 · 被引用次数：10 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Intracranial Aneurysms: Treatment and Complications、Neurological Disease Mechanisms and Treatments

Background The relationship between plaque characteristics and their predictive value for perioperative cerebral blood flow (CBF) are unknown. Purpose To investigate the relationship between carotid plaque characteristics and perioperative CBF utilizing MRI. Study Type Prospective. Population In all, 131 patients with carotid moderate‐to‐severe stenosis referred for carotid endarterectomy (CEA). Field Strength/Sequence 3T, black‐blood T 1 ‐ and T 2 ‐weighted, 3D time‐of‐flight, and simultaneous noncontrast angiography intraplaque hemorrhage. Assessment The relative CBF (rCBF = CBF index‐hemisphere /CBF contralateral‐hemisphere ) and the CBF difference ratio (DR CBF = [CBF post‐CEA – CBF pre‐CEA ]/CBF pre‐CEA ) in the middle cerebral artery territory were measured. The pre‐ and post‐CEA CTP data were used as the assessment standard for CBF change. Carotid lipid‐rich necrotic core (LRNC), intraplaque hemorrhage, calcification, fibrous cap rupture, maximum wall thickness, normalized wall index (NWI), and stenosis were determined. Statistical Tests Pearson or Spearman correlation, Mann–Whitney U ‐test, and linear regression. Results Patients with LRNC had higher rCBF pre‐CEA than those without (1.0 ± 0.1 vs. 0.9 ± 0.1, P < 0.05). NWI was weakly correlated with rCBF pre‐CEA ( r = −0.213, P < 0.05) and DR CBF ( r = 0.185, P < 0.05) and marginally correlated with rCBF post‐CEA ( r = 0.166, P = 0.057). LRNC was weakly correlated with rCBF pre‐CEA ( r = 0.179, P < 0.05). N...