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Diagram of location of carotid plaques. The location of plaques was determined according to the WTmax located above or below carotid bifurcation. (WTmax, maximum wall thickness; ICA, internal carotid artery; ECA, external carotid artery; CCA, common carotid artery; BIF, bifurcation of carotid artery)
Source publication
Purpose
This study aimed to investigate the segment-specific progression of atherosclerotic carotid plaques using serial multi-contrast magnetic resonance (MR) imaging.
Methods
Symptomatic patients with carotid 30–70% stenosis were recruited and underwent carotid MR vessel wall imaging at baseline and follow-up time point (≥ 6 months after baselin...
Citations
... This study found that the proportion of subjects with diabetes and hypertension increased with the severity of plaque. This may be caused by disorders of glucose and lipid metabolism in most diabetes or hypertension patients, and the incidence of carotid plaques is increased [24][25][26][27][28]. Thus, in further analysis, we compared subjects with diabetes, hypertension and those without these two diseases. ...
Background:
MHR is the ratio of monocyte to high-density lipoprotein cholesterol (HDL-C). It has been reported that MHR changes are associated with cardiovascular and cerebrovascular disease. Carotid plaque is a common vascular lesion of the carotid artery and is a manifestation of atherogenesis. This study investigated the relationships between the MHR and the incidence of carotid plaques.
Methods:
The data of 3848 physical examiners were analyzed for retrospective analysis, which included 1428 patients with noncarotid plaque, 1133 patients with single carotid plaque, and 1287 patients with bilateral or multiple carotid plaques. Statistical analysis was performed on SPSS 22.0 0 software and statistical software R and its GAM package.
Results:
The difference was statistically significant in the levels of MHR, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), blood lipids (HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (Tg)), blood glucose (Glu), hemoglobin A1c (HbA1c), renal function (urea, creatinine (Crea)), estimated glomerular filtration rate (eGFR), and uric acid (Ua) in the carotid plaque groups (P < 0.001, respectively). There was no significant difference between the sex (P = 0.635) and age (P = 0.063) in the different groups. MHR levels were positively correlated with BMI (r = 0.364, P < 0.001), hs-CRP (r = 0.320, P < 0.001), Tg (r = 0.417, P < 0.001), Crea (r = 0.323, P < 0.001), eGFR (r = - 0.248, P < 0.001), Ua (r = 0.383, P < 0.001) and HbA1c (r = 0.197, P < 0.001). Levels of TC, Glu, and urea were slightly correlated with the MHR level (r = - 0.150, P < 0.001; r = 0.187, P < 0.001; r = 0.137, P < 0.001, respectively). The MHR level increased with elevated severity of carotid plaque in subjects without hypertension or diabetes (P < 0.001). In adjusted models, with the rise of MHR level, the probability of occurrence of carotid plaque had a 1.871-fold (95% CI: 1.015-3.450, P = 0.045) increase; the probability of multiple occurrences of carotid plaques had a 2.896-fold (95% CI: 1.415-5.928, P < 0.001) increase. The GAM curve showed a nonlinear correlation between the normalized MHR and the probability of carotid plaque occurrence.
Conclusions:
MHR could be used as a possible marker for plaque formation and severity.
... This study found that the proportion of subjects with diabetes and hypertension did rise with the severity of plaque. This may caused by disorders of glucose and lipid metabolism in most diabetes or hypertension patients, and the incidence of carotid plaques is increased [29][30][31][32][33]. Thus in further analysis, we compared subjects with diabetes, hypertension and those without these two diseases respectively. ...
Background: Carotid plaque is a manifestation of carotid atherosclerosis,monocytes play a key role in atherosclerosis related inflammatory response ,high density lipoprotein cholesterol (HDL-C) has vascular protective effects such as anti-inflammatory, antithrombotic and anti atherosclerosis. This study is to investigate the relationships of MHR level and the incidence of carotid artery plaque.
Methods: Data of physical examination personnel in the first medical center of the General Hospital of PLA from January to April in 2018 was collected and 3848 subjects were included for retrospectively analysis. Statistical analysis was performed on Spss 22.0 0 software and statistical software R and its GAM package.
Results: The difference was statistically significant in levels of MHR, body mass index (BMI), high-sensitive C-reactive protein (hs-CRP), blood lipids (HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), triglyceride(Tg)), blood glucose(Glu), Hyperglycemic hemoglobin(HbA1c), renal function (Urea, creatinine(Crea), estimated glomerular filtration rate(eGFR), Uric acid (Ua)) in carotid plaque groups (p=0.000,respectively). No significant difference between the gender (p=0.635) and age(p=0.063) in different groups. MHR levels was positively correlated with levels of BMI (r = 0.364, P = 0.000), hs-CRP (r = 0.320, P =0.000), Tg (r = 0.417, P=0.000), Crea(r=0.323, P=0.000), eGFR(r=-0.248, P=0.000), Ua(r=0.383, P=0.000) and HbA1c (r=0.197, P=0.000). Levels of TC, Glu, Urea were slightly correlated with MHR level(r=-0.150, P=0.000; r=0.187, P=0.000; r=0.137, P=0.000; respectively ). In subjects with both hypertension and diabetes, MHR levels showed difference among three groups (p=0.009). MHR level increased with elevated site number of carotid plaque in subjects without hypertension or diabetes(p=0.000). MHR level still showed differences among carotid plaque groups in subjects with hypertension and diabetes. In adjusted models, the probability of occurrence of carotid plaque increased by1.958 (95% CI: 1.144-3.351, P = 0.000) times; The probability of multiple occurrence of carotid plaques increased by 2.068 (95% CI: 1.100-3.887, P = 0.000) times. The GAM curve showed a non-linear correlation between normalized MHR and the probability of carotid plaque occurrence.
Conclusions: MHR could be used as an independent risk factor and indicator for plaque formation and severity.
... The analysis of carotid artery from magnetic resonance (MR) images is a significant study for detecting, evaluating and diagnosing carotid atherosclerosis. Multi-contrast MR sequences are usually utilized to observe the state of carotid artery [1][2][3], and it is an accurate image technique helping to better characterize the physiopathological dynamics [4] compared with ultrasound imaging. Accurate carotid segmentation can help researchers and doctors quantitatively estimate the degree of carotid stenosis and measure the volume of plaque, which is an important indicator for clinical diagnosis [5]. ...
Carotid atherosclerosis is one of the leading causes of cardiovascular disease with high mortality. Multi-contrast MRI can identify atherosclerotic plaque components with high sensitivity and specificity. Accurate segmentation of the diseased carotid artery from MR images is very essential to quantitatively evaluate the state of atherosclerosis. However, due to the complex morphology of atherosclerosis plaques and the lack of well-annotated data, the segmentation of lumen and wall is very challenging. Different from popular deep learning methods, in this paper, we propose an integration segmentation framework by introducing a lightweight prediction model and improved optimal surface graph cuts (OSG), which adopts a simplified flow line sampling and post-reconstructing method to reduce the cost of graph construction. Moreover, a flexibly adaptive smoothing penalty is presented for maintaining the shape of diseased carotid surface. For the experiments, we have collected an MR image dataset from patients with carotid atherosclerosis and evaluated our method by cross-validation. It can reach 89.68%/80.29% of dice coefficients and 0.2480 mm/0.3396 mm of average surface distances on the lumen/wall segmentation, respectively. The experimental results show that our method can generate precise and reliable segmentation of both lumen and wall of diseased carotid artery with a quite small training cost.
... 36 The progression rate of atherosclerosis in ICA is faster than CCA segment. 37,38 Our finding, along with Lu 35 et al, suggests that these differences in early stage may finally lead to an incidence difference of vulnerable plaques. The underlying mechanism of such segment difference is not yet clear. ...
Objective:
Carotid bifurcation geometry has been believed to be a risk factor for the initiation of atherosclerosis because of its influence on hemodynamics. However, the relationships between carotid bifurcation geometry and plaque vulnerability are not fully understood. This study aimed to determine the association between carotid bifurcation geometry and plaque vulnerability using magnetic resonance vessel wall imaging. Approach and Results: A total of 501 carotid arteries with nonstenotic atherosclerosis were included from the cross-sectional, multicenter CARE II study (Chinese Atherosclerosis Risk Evaluation). Four standardized carotid bifurcation geometric parameters (bifurcation angle, internal carotid artery planarity, luminal expansion FlareA, and tortuosity Tort2D) were derived from time-of-flight magnetic resonance imaging. Presence of vulnerable plaque, which has intraplaque hemorrhage, large lipid-rich necrotic core, or disrupted luminal surface, was determined based on multicontrast carotid magnetic resonance vessel wall images. Vulnerable plaques (N=43) were found to occur at more distal locations (ie, near the level of flow divider) than stable plaques (N=458). Multivariable logistic regression shows that the luminal expansion FlareA (odds ratio, 0.45 [95% CI, 0.25-0.81]; P=0.008) was associated with plaque vulnerability after adjustment for age, sex, maximum wall thickness, plaque location, and other geometric parameters.
Conclusions:
Smaller luminal expansion at carotid bifurcation is associated with vulnerable plaque. The finding needs to be verified with longitudinal studies and the underlying mechanism should be further explored with hemodynamics measurement in the future.
Aims
Carotid atherosclerosis (CAS) is associated with a high risk of cardiovascular diseases. We aimed to investigate whether CAS is associated with the presence of intracranial atherosclerosis (ICAS).
Methods
A total of 69 asymptomatic patients with type 2 diabetes (36 with CAS and 33 without CAS) who were free of cerebrovascular disease were enrolled in this case-control study. CAS was defined as a mean carotid intima-media thickness ≥ 1.0 mm or carotid plaque. The presence of ICAS was identified using three-dimensional high-resolution vessel wall magnetic resonance imaging.
Results
There was no difference between the case and control groups in baseline characteristics, such as age, the proportion of men, duration of diabetes, and other cardiometabolic risk factors. The prevalence of ICAS was significantly higher in patients with CAS than those without CAS (72.2% vs. 48.5%, P = 0.044). CAS was significantly associated with the presence of ICAS, even after adjusting other covariates (odds ratio [OR], 3.19; 95% confidence interval [CI] 1.09–9.33, P = 0.034). In addition, CAS was significantly associated with the presence of multiple ICAS lesions (OR, 5.57; 95% CI 1.75–17.78, P = 0.004).
Conclusions
CAS is significantly and independently associated with the presence and extent of ICAS in patients with type 2 diabetes.
Carotid artery stenosis (CAS) due to the presence of atherosclerotic plaque (AP) is a frequent medical condition and a known risk factor for stroke, and it is also known from literature that several risk factors promote the AP development, in particular aging, smoke, male sex, hypertension, hyperlipidemia, smoke, diabetes type 1 and 2, and genetic factors. The study of carotid atherosclerosis is continuously evolving: even if the strategies of treatment still depends mainly on the degree of stenosis (DoS) determined by the plaque, in the last years the attention has moved to the study of the plaque components in order to identify the so called "vulnerable" plaque: features like the fibrous cap status and thickness, the volume of the lipid-rich necrotic core and the presence of intraplaque hemorrhage (IPH) are risk factors for plaque rupture, that can be studied with modern imaging techniques. The aim of this review is to give a general overview of the principle histological and imaging features of the subcomponent of carotid AP (CAP), focalizing in particular on the features of CAP of patients affected by hypertension and diabetes (in particular type 2 diabetes mellitus).
