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(Stroke. 2006;37:767-a.)
© 2006 American Heart Association, Inc.

Letters to the Editor

Magnetic Resonance Direct Thrombus Imaging in Moderate Carotid Artery Stenosis

Lucy R. Daniels, MRCP John R. Gladman, FRCP

Department of Rehabilitation and Ageing, University of Nottingham, Queen’s Medical Centre, Nottingham, UK

Nishath Altaf, MRCS

Department of Vascular Surgery, University of Nottingham, Queen’s Medical Centre, Nottingham, UK

Alan R. Moody, FRCR

Department of Radiology, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Wasserman et al¹ present a proof-of-concept case elegantly demonstrating that high-resolution MRI of carotid plaque can identify a lesion that was highly likely to be causing cerebrovascular symptoms even though it was not causing significant stenosis of the carotid lumen. The authors also acknowledge that acquiring high-resolution MR images is time-consuming and requires the injection of contrast.

We too are interested in using MR techniques to find features of carotid artery plaque related to its biological behavior, rather than simply the degree of stenosis caused by it. We have explored magnetic resonance direct thrombus imaging (MRDTI) on the basis that thrombus associated with plaque is likely to be important in disease progression or to be the crucial final step before plaques give rise to cerebrovascular symptoms.² MRDTI takes only 5.3 minutes to acquire, and no contrast is required, making it potentially more easy to use than high-resolution MRI. MRDTI is sensitive and specific for complicated plaque in symptomatic patients with >70% stenosis coming to carotid endarterectomy.³ We are currently undertaking a longitudinal study of MRDTI in symptomatic patients with lesser degrees of carotid stenosis who, in our center, are not routinely offered carotid endarterectomy. We present the following case from our series which illustrates how this technique, like high-resolution MRI, can be clinically valuable.

Mr G was a 68-year-old man who had 2 episodes of loss of power affecting his right arm in September 2002. Duplex ultrasound (undertaken 10 days after the event) showed 30% to 50% . . . [Full Text of this Article]

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