Published Online
on May 1, 2008

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Submitted on September 18, 2007
Revised on November 24, 2007
Accepted on November 28, 2007

Correlation of Carotid Atheromatous Plaque Inflammation Using USPIO-Enhanced MR Imaging With Degree of Luminal Stenosis

Tjun Y. Tang MRCS; Simon P.S. Howarth MRCS; Sam R. Miller MSc; Martin J. Graves MSc; Jean-Marie U-King-Im MRCS; Zhi-Yong Li PhD; Stewart R. Walsh MSc; Andrew J. Patterson PhD; Peter J. Kirkpatrick FMedSci; Elizabeth A. Warburton DM; Kevin Varty MD; Michael E. Gaunt MD; and Jonathan H. Gillard MD^*

From the University Department of Radiology (T.Y.T., S.P.S.H., M.J.G., J.M.U., Z.Y.L., A.J.P., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Biostatistics and Data Sciences (S.R.M.), GlaxoSmithKline, Harlow, UK; Cambridge Vascular Unit (T.Y.T., S.R.W., K.V., M.E.G.), Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Academic Department of Neurosurgery (S.P.S.H., P.J.K.), Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; and the Department of Clinical Neurosciences (E.A.W.), Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

^* To whom correspondence should be addressed. E-mail: jhg21{at}cam.ac.uk.

Background and Purpose—Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque. The study explores the relationship between the degree of Magnetic Resonance (MR)–defined inflammation using Ultra Small Super-Paramagnetic Iron Oxide (USPIO) particles and the severity of luminal stenosis in asymptomatic carotid plaques.

Methods—Seventy-one patients with an asymptomatic carotid stenosis of 40% underwent multi-sequence USPIO-enhanced MR imaging. Stenosis severity was measured according to the NASCET and ECST methods.

Results—No demonstrable relationship between inflammation as measured by USPIO-enhanced signal change and the degree of luminal stenosis was found.

Conclusions—Inflammation and stenosis are likely to be independent risk factors, although this needs to be further validated.

Key words: asymptomatic carotid stenosis • atherosclerosis • USPIO • MRI • inflammation • plaque vulnerability