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Is Carotid Plaque Contrast Enhancement on MRI Predictive for Cerebral or Cardiovascular Events? A Prospective Cohort Study

Papini, Giacomo Davide Edoardo MD; Di Leo, Giovanni MSc; Bandirali, Michele MD; Cotticelli, Biagio MD; Flor, Nicola MD; Restivo, Pietro MD; Nano, Giovanni MD; Sardanelli, Francesco MD

Journal of Computer Assisted Tomography: March/April 2017 - Volume 41 - Issue 2 - p 321–326
doi: 10.1097/RCT.0000000000000506
Vascular Imaging

Objective The aim of this study was to correlate carotid plaque contrast enhancement (CPCE) to onset of cerebral/cardiovascular events (CCVE) in patients with atherosclerotic carotid disease.

Methods The ethics committee approved this prospective study. Patients with carotid artery stenosis underwent magnetic resonance angiography before/after injection of 0.1 mmol/kg of gadobenate dimeglumine. Carotid plaque contrast enhancement was graded as follows: 0, no CPCE; 1, 1 single enhancement focus; 2, 2 or more foci.

Results Seventy-seven patients (71 ± 9 years) had a stenosis degree: 34 mild, 16 moderate, 27 severe at the right side, and 36, 15, and 25 at the left side. Carotid plaque contrast enhancement was 0 in 30 patients, 1 in 26, 2 in 11 at the right, and 37, 19, and 13 at the left. Forty-seven CCVE occurred after magnetic resonance imaging, correlated to both stenosis degree (P = 0.006) and CPCE (P = 0.032). Excluding surgery/stenting, the correlation held only for CPCE (P = 0.017). Of 49 patients showing CPCE, 5 (10%) reported CCVE; of 21 patients without CPCE, none reported CCVE (P = 0.129).

Conclusions The absence of CPCE seems to be a negative predictor for CCVE.

From the *Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; †Unità Operativa di Radiologia Diagnostica e Interventistica, Azienda Ospedaliera San Paolo, Milan, Italy; ‡Vascular Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; and §Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, San Donato Milanese, Italy.

Received for publication April 29, 2016; accepted June 7, 2016.

Correspondence to: Giovanni Di Leo, MSc, Radiology Unit, IRCCS Policlinico San Donato, Piazza E. Malan 2, 20097 San Donato Milanese, Italy (e-mail:

F. Sardanelli is on the speaker's bureau for Bracco Imaging SpA (Milan) and received research grants from Bayer Healthcare AG (Berlin). G. Di Leo and G.D.E. Papini were sponsored to congresses by Bracco Imaging SpA (Milan).

The authors declare no conflict of interest.

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