Neovascularization in Vertebral Artery Atheroma-A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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Usman, A., Yuan, J., Patterson, A., Graves, M., Varty, K., Sadat, U., & Gillard, J. (2018). Neovascularization in Vertebral Artery Atheroma-A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease.. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 27 (9), 2505-2512. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.05.011
Abstract Background: Atherosclerosis is a systemic inflammatory disease intertwined with neovascularisation. Dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging enables the assessment of plaque neovascularisation. This study aimed to explore systemic nature of atherosclerosis by assessing difference in severity of neovascularisation as quantified by DCE-MR imaging of vertebral arteries (VA) between patients with symptomatic and asymptomatic carotid artery disease. Methods: 10 consecutive patients with asymptomatic vertebral artery stenosis and concomitant symptomatic carotid artery disease (group 1); and 10 consecutive patients with asymptomatic vertebral artery stenosis and concomitant asymptomatic carotid artery disease (group 2), underwent 3D DCE-MRI of their cervical segment of vertebral arteries. A previously validated pharmacokinetic modelling approach was used for DCE-MR analysis. Ktrans was calculated in the adventitia and plaque as a measure of neovessel permeability. Results: Both patient groups were comparable for demographics and co-morbidities. Mean luminal stenosis was comparable for both groups (54.4% vs 52.27%, p= 0.32). Group 1 had higher adventitial Ktrans and plaque Ktrans (0.08 ± 0.01min-1, 0.07± 0.01min-1 compared to Group 2 (0.06± 0.01 min-1, 0.06± 0.01min-1), (p =0.004 and 0.03) respectively. Good correlation was present among the two image analysts (ICC coefficient=0.78). Conclusions Vertebral artery atheroma of patients with symptomatic carotid artery disease had increased neovessel permeability compared to the patients with asymptomatic carotid artery disease. These findings are consistent with the hypothesis that atherosclerosis is a systemic inflammatory disease. The vertebral artery atherosclerosis is likely to have increased severity of neovascularisation if another arterial territory is symptomatic in the same patient cohort.
Vertebral Artery, Vasa Vasorum, Humans, Carotid Artery Diseases, Constriction, Pathologic, Neovascularization, Pathologic, Contrast Media, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Aged, Aged, 80 and over, Middle Aged, Female, Male, Plaque, Atherosclerotic
NIHR and Biomedical Research Centre award to the Cambridge University Hospitals NHS Foundation Trust
Addenbrooke's Charitable Trust (ACT) (CT/9259)
This record's URL: https://www.repository.cam.ac.uk/handle/1810/283394