Comparison of symptomatic and asymptomatic atherosclerotic carotid plaques using parallel imaging and 3 T black-blood in vivo CMR

Background: To determine if black-blood 3 T cardiovascular magnetic
resonance (bb-CMR) can depict differences between symptomatic and
asymptomatic carotid atherosclerotic plaques in acute ischemic
stroke patients. Methods: In this prospective monocentric
observational study 34 patients (24 males; 70 +/- 9.3 years) with
symptomatic carotid disease defined as ischemic brain lesions in
one internal carotid artery territory on diffusion weighted images
underwent a carotid bb-CMR at 3 T with fat-saturated pre- and
post-contrast T1w-, PDw-, T2w- and TOF images using surface coils
and Parallel Imaging techniques (PAT factor = 2) within 10 days
after symptom onset. All patients underwent extensive clinical
workup (lab, brain MR, duplex sonography, 24-hour ECG,
transesophageal echocardiography) to exclude other causes of
ischemic stroke. Prevalence of American Heart Association lesion
type VI (AHA-LT6), status of the fibrous cap, presence of
hemorrhage/thrombus and area measurements of calcification,
necrotic core and hemorrhage were determined in both carotid
arteries in consensus by two reviewers who were blinded to clinical
information. McNemar and Wilcoxon's signed rank tests were use for
statistical comparison. A p-value