Magnetic resonance imaging characteristics of unilateral versus bilateral intraplaque hemorrhage in patients with carotid atherosclerotic plaques / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the difference in the vulnerability of carotid atherosclerotic plaques in patients with unilateral and bilateral intraplaque hemorrhage (IPH).</p><p><b>METHODS</b>A retrospective analysis was conducted among 44 patients with unilateral IPH (30 cases) or bilateral IPH (14 cases) in the carotid plaques detected by magnetic resonance imaging (MRI) in our hospital between December, 2009 and December, 2012. The age, maximum wall thickness and incidence of fibrous cap rupture were compared between the two groups.</p><p><b>RESULTS</b>Compared with those with unilateral IPH, the patients with bilateral IPHs had a significantly younger age (66.6∓9.4 years vs 73.7∓9.0 years, P=0.027), a significantly greater maximum plaque thickness (6.3∓1.9 mm vs 5.0∓1.3 mm, P=0.035) and a higher incidence of ulcers (50% vs 13.3%, P=0.025). Logistic regression analysis revealed a significant association between bilateral IPHs and the occurrence of ulcer with an odd ratio (OR) of 6.5 (95% confidence interval [CI]: 1.5-28.7, P=0.014). After adjustment for gender in Model 1, bilateral IPHs were still significantly associated with presence of ulcer (OR=5.7, 95%CI: 1.1-29.2, P=0.036). But after adjustment for age (P=0.131) or maximum plaque thickness (P=0.139) in model 2, no significant correlation was found between bilateral IPHs and the presence of ulcer.</p><p><b>CONCLUSION</b>Compared with patients with unilateral IPH, those with bilateral IPHs are at a younger age and have a greater plaque burden and a higher incidence of fibrous cap rupture, suggesting a greater vulnerability of the carotid plaques in patients with bilateral IPHs.</p>

Neovascularization in the carotid atherosclerotic plaque is not associated with inflammatory cell aggregation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Monocytes and macrophages in atherosclerotic plaque lead to plaque instability. The aim of the study was to determine if plaque neovascularization led to inflammation.</p><p><b>METHODS</b>Patients were consecutively enrolled if their carotid intimal media thickness was > 2 mm, as revealed by duplex ultrasound. The patients then underwent dynamic contrast enhanced magnetic resonance imaging (DCE MRI) and fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography combined with computed tomography (PET CT). A target to background ratio (TBR) of ≥ 1.25 or < 1.25 served as the cutoff point for the presence and absence of inflammation, respectively.</p><p><b>RESULTS</b>Twenty-six patients underwent bilateral carotid DCE MRI and 24 patients also underwent PET CT. One hundred and fifty-five plaques were evaluated by both DCE MRI and PET CT. There was no significant difference in plaque morphology between the TBR ≥ 1.25 (n = 61) and TBR < 1.25 (n = 94) groups. No significant differences were found in plasma volume and transfer constant between the TBR ≥ 1.25 and TBR < 1.25 groups.</p><p><b>CONCLUSION</b>Our study did not find a significant correlation between plaque neovascularization and the aggregation of inflammatory cells.</p>

Evaluation of coronary artery in-stent restenosis using 64-slice CT / 中华放射学杂志

Objective To evaluate the accuracy of 64-slice CT in the diagnosis of coronary in-stent restenosis (ISR).Methods Fourteen patients with 37 implanted coronary stents were examined by both 64-slice CT angiography (CTA) and conventional coronary angiography(CCA).The diagnosis of ISR was evaluated by two methods(visual inspection and the measurement of the in-stent contrast attenuation)on CTA.The accuracy of the two methods in the diagnosis of ISR was compared with reference to CCA.Results ISR(＞50%)was found on CCA in 11 stents.CTA with visual inspection and with measurement of in-stent CT attenuation correctly detected ISR in 2 and 3 stents respectively with reference to CCA.The sensitivity, specificity,positive predictive value and negative predicitive value of the two methods were 18%,69%, 20%,67% and 27%,81%,38%,72%,respectively.There was no significant difference (P＞0.05) between the accuracy of two methods.Conclusion The ISR was very difficult to diagnose by 64 slice CT, but the high specificity of 64-slice CT study implied an important role in excluding ISR.