Clinical and histological significance of gadolinium enhancement in carotid atherosclerotic plaque. 2012

Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
Department of Vascular Surgery, University Hospital of Lyon, Lyon University, Lyon, France. antoinemillon@hotmail.com

OBJECTIVE Although the ability of MRI to investigate carotid plaque composition is well established, the mechanism and the significance of plaque gadolinium (Gd) enhancement remain unknown. We evaluated clinical and histological significance of Gd enhancement of carotid plaque in patients undergoing endarterectomy for carotid stenosis. METHODS Sixty-nine patients scheduled for a carotid endarterectomy prospectively underwent a 3-T MRI. Carotid plaque enhancement was assessed on T1-weighted images performed before and 5 minutes after Gd injection. Enhancement was recorded according to its localization. Histological analysis was performed of the entire plaque and of the area with matched contrast enhancement on MR images. RESULTS Gd enhancement was observed in 59% patients. Three types of carotid plaques were identified depending on enhancement location (shoulder region, shoulder and fibrous cap, and central in the plaque). Fibrous cap rupture, intraplaque hemorrhage, and plaque Gd enhancement was significantly more frequent in symptomatic than in asymptomatic patients (P=0.043, P<0.0001, and P=0.034, respectively). After histological analysis, Gd enhancement was significantly associated with vulnerable plaque (American Heart Association VI, P=0.006), neovascularization (P<0.0001), macrophages (P=0.030), and loose fibrosis (P<0.0001). Prevalence of neovessels, macrophages, and loose fibrosis in the area of Gd enhancement was 97%, 87%, and 80%, respectively, and was different depending on the enhancement location in the plaque. Fibrous cap status and composition were different depending on the type of plaque. CONCLUSIONS Gd enhancement of carotid plaque is associated with vulnerable plaque phenotypes and related to an inflammatory process.

UI MeSH Term Description Entries
D007089 Image Enhancement Improvement of the quality of a picture by various techniques, including computer processing, digital filtering, echocardiographic techniques, light and ultrastructural MICROSCOPY, fluorescence spectrometry and microscopy, scintigraphy, and in vitro image processing at the molecular level. Image Quality Enhancement,Enhancement, Image,Enhancement, Image Quality,Enhancements, Image,Enhancements, Image Quality,Image Enhancements,Image Quality Enhancements,Quality Enhancement, Image,Quality Enhancements, Image
D007090 Image Interpretation, Computer-Assisted Methods developed to aid in the interpretation of ultrasound, radiographic images, etc., for diagnosis of disease. Image Interpretation, Computer Assisted,Computer-Assisted Image Interpretation,Computer-Assisted Image Interpretations,Image Interpretations, Computer-Assisted,Interpretation, Computer-Assisted Image,Interpretations, Computer-Assisted Image
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D002537 Intracranial Arteriosclerosis Vascular diseases characterized by thickening and hardening of the walls of ARTERIES inside the SKULL. There are three subtypes: (1) atherosclerosis with fatty deposits in the ARTERIAL INTIMA; (2) Monckeberg's sclerosis with calcium deposits in the media and (3) arteriolosclerosis involving the small caliber arteries. Clinical signs include HEADACHE; CONFUSION; transient blindness (AMAUROSIS FUGAX); speech impairment; and HEMIPARESIS. Cerebral Arteriosclerosis,Intracranial Atherosclerosis,Cerebral Atherosclerosis,Arterioscleroses, Cerebral,Arterioscleroses, Intracranial,Arteriosclerosis, Cerebral,Arteriosclerosis, Intracranial,Atheroscleroses, Cerebral,Atheroscleroses, Intracranial,Atherosclerosis, Cerebral,Atherosclerosis, Intracranial,Cerebral Arterioscleroses,Cerebral Atheroscleroses,Intracranial Arterioscleroses,Intracranial Atheroscleroses
D005682 Gadolinium An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D016893 Carotid Stenosis Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3) Carotid Artery Narrowing,Carotid Ulcer,Carotid Artery Plaque,Carotid Artery Stenosis,Carotid Artery Ulcerating Plaque,Common Carotid Artery Stenosis,External Carotid Artery Stenosis,Internal Carotid Artery Stenosis,Plaque, Ulcerating, Carotid Artery,Stenosis, Common Carotid Artery,Stenosis, External Carotid Artery,Ulcerating Plaque, Carotid Artery,Artery Narrowing, Carotid,Artery Narrowings, Carotid,Artery Plaque, Carotid,Artery Plaques, Carotid,Artery Stenoses, Carotid,Artery Stenosis, Carotid,Carotid Artery Narrowings,Carotid Artery Plaques,Carotid Artery Stenoses,Carotid Stenoses,Carotid Ulcers,Narrowing, Carotid Artery,Narrowings, Carotid Artery,Plaque, Carotid Artery,Plaques, Carotid Artery,Stenoses, Carotid,Stenoses, Carotid Artery,Stenosis, Carotid,Stenosis, Carotid Artery,Ulcer, Carotid,Ulcers, Carotid
D016894 Endarterectomy, Carotid The excision of the thickened, atheromatous tunica intima of a carotid artery. Carotid Endarterectomy,Carotid Endarterectomies,Endarterectomies, Carotid
D058226 Plaque, Atherosclerotic Lesions formed within the walls of ARTERIES associated with deposits of fat and other substances that accumulate in the lining of the artery wall. Atheromatous Plaque,Atheroma,Atheromatous Plaques,Atherosclerotic Plaque,Atherosclerotic Plaques,Fatty Streak, Arterial,Fibroatheroma,Fibroatheromatous Plaques,Arterial Fatty Streak,Arterial Fatty Streaks,Atheromas,Fibroatheromas,Fibroatheromatous Plaque,Plaque, Atheromatous,Plaque, Fibroatheromatous,Streak, Arterial Fatty

Related Publications

Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
December 2021, Neurological research,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
November 1997, Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
February 1999, Cardiovascular research,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
September 1990, Archives of neurology,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
August 2016, Journal of the American Heart Association,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
October 2019, AJNR. American journal of neuroradiology,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
January 2004, Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
April 2023, European review for medical and pharmacological sciences,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
November 2004, Medical science monitor : international medical journal of experimental and clinical research,
Antoine Millon, and Loic Boussel, and Marie Brevet, and Jean-Louis Mathevet, and Emmanuelle Canet-Soulas, and Cyril Mory, and Jean-Yves Scoazec, and Philippe Douek
December 1994, International angiology : a journal of the International Union of Angiology,
Copied contents to your clipboard!