Value Of Bilateral Carotid Plaque MRI Feature In Prediction Of Acute Cerebral Infarction

Objective To investigate the difference of symptomatic side carotid plaque feature and the contralateral side,and to analyze the predictive value of symptomatic carotid vulnerable plaque and bilateral carotid vulnerable plaque in acute cerebral infarction(ACI).Materials and methods Patients with cerebral ischemia symptoms and carotid plaque were enrolled for carotid and brain magnetic resonance imaging to compare the plaque burden and component of bilateral carotid plaque.The vulnerability of bilateral carotid plaque and whether the corresponding ACI occurs were analyzed to evaluate the predictive value of symptomatic carotid vulnerable plaque and bilateral carotid vulnerable plaque in ACI.Independent sample t-test and chi-square test were used to compare the plaque burden and component characteristics between symptomatic side and the contralateral side.The odds ratio(OR)and 95% confidence interval(CI)of plaque characteristics in predicting ACI were calculated by univariate and multivariate logistic regression models.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of symptomatic carotid plaque and bilateral carotid plaque.Results A total of 97 patients were enrolled.The plaque burden of symptomatic carotid plaque were heavier than the contralateral side.Lipid-rich necrotic core and intraplaque hemmorhage were significantly different between two sides,while there was no significant difference in calcification between two sides.Both symptomatic carotid vulnerable plaque(OR 4.39,95%CI 1.33~14.56,P=0.015)and combined bilateral carotid vulnerable plaque(OR 5.88,95%CI 1.81~19,P=0.003)were associated with ACI.The area under the curve(AUC)to predict ACI was 0.63(95%CI 0.52~0.75,p =0.023)and 0.72(95% CI 0.61~0.82,P<0.001),respectively.Conclusion This study shows symptomatic carotid plaque are with heavier plaque burden and more vulnerable feature.Symptomatic carotid plaque are associated with ACI,and combined bilateral carotid vulnerable plaque can further enhance the predictive value of ACI.