Carotid magnetization-prepared rapid acquisition with gradient-echo signal is associated with acute territorial cerebral ischemic events detected by diffusion-weighted MRI

J. Scott McNally, Seong Eun Kim, Hyo Chun Yoon, Laura Findeiss, John A. Roberts, Daniel R. Nightingale, Krishna K. Narra, Dennis L. Parker, Gerald S. Treiman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background-Carotid intraplaque hemorrhage has been associated with symptomatic stroke and can be accurately detected with magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Currently, there are no studies analyzing carotid MPRAGE signal and territorial ischemic events defined by diffusion restriction in the acute setting. Our aim was to determine the association of carotid MPRAGE signal with acute territorial ischemic events using carotid MPRAGE and brain diffusion tensor imaging. Methods and Results-After the addition of the MPRAGE sequence to the neck MR angiographic protocol, 159 patients with suspected acute stroke were evaluated with both brain diffusion tensor imaging and carotid MPRAGE sequences over 2 years, providing 318 carotid artery and paired brain images for analysis. Forty-eight arteries were excluded due to extracarotid sources of brain ischemia and 4 were excluded due to carotid occlusion. Two hundred sixty-six arteries were eligible for data analysis. Carotid MPRAGE-positive signal was associated with an acute cerebral territorial ischemic event with a relative risk of 6.4 (P<0.001). The relative risk of a diffusion tensor imaging-positive territorial ischemic event with carotid MPRAGE-positive signal was increased in mild, moderate, and severe stenosis categories (10.3, P<0.001; 2.9, P=0.01; and 2.2, P=0.01, respectively). Conclusions-In the workup of acute stroke, carotid MPRAGE-positive signal was associated with an increased risk of territorial cerebral ischemic events as detected objectively by brain diffusion tensor imaging. The relative risk of stroke was increased in all carotid stenosis categories but was most elevated in the mild stenosis category.

Original languageEnglish (US)
Pages (from-to)376-382
Number of pages7
JournalCirculation: Cardiovascular Imaging
Volume5
Issue number3
DOIs
StatePublished - May 1 2012

Fingerprint

Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Stroke
Brain
Pathologic Constriction
Arteries
Carotid Stenosis
Brain Ischemia
Carotid Arteries
Neck
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Carotid magnetization-prepared rapid acquisition with gradient-echo signal is associated with acute territorial cerebral ischemic events detected by diffusion-weighted MRI. / McNally, J. Scott; Kim, Seong Eun; Yoon, Hyo Chun; Findeiss, Laura; Roberts, John A.; Nightingale, Daniel R.; Narra, Krishna K.; Parker, Dennis L.; Treiman, Gerald S.

In: Circulation: Cardiovascular Imaging, Vol. 5, No. 3, 01.05.2012, p. 376-382.

Research output: Contribution to journalArticle

McNally, J. Scott ; Kim, Seong Eun ; Yoon, Hyo Chun ; Findeiss, Laura ; Roberts, John A. ; Nightingale, Daniel R. ; Narra, Krishna K. ; Parker, Dennis L. ; Treiman, Gerald S. / Carotid magnetization-prepared rapid acquisition with gradient-echo signal is associated with acute territorial cerebral ischemic events detected by diffusion-weighted MRI. In: Circulation: Cardiovascular Imaging. 2012 ; Vol. 5, No. 3. pp. 376-382.
@article{1dbf33663d264d9ca7324b615f1822b0,
title = "Carotid magnetization-prepared rapid acquisition with gradient-echo signal is associated with acute territorial cerebral ischemic events detected by diffusion-weighted MRI",
abstract = "Background-Carotid intraplaque hemorrhage has been associated with symptomatic stroke and can be accurately detected with magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Currently, there are no studies analyzing carotid MPRAGE signal and territorial ischemic events defined by diffusion restriction in the acute setting. Our aim was to determine the association of carotid MPRAGE signal with acute territorial ischemic events using carotid MPRAGE and brain diffusion tensor imaging. Methods and Results-After the addition of the MPRAGE sequence to the neck MR angiographic protocol, 159 patients with suspected acute stroke were evaluated with both brain diffusion tensor imaging and carotid MPRAGE sequences over 2 years, providing 318 carotid artery and paired brain images for analysis. Forty-eight arteries were excluded due to extracarotid sources of brain ischemia and 4 were excluded due to carotid occlusion. Two hundred sixty-six arteries were eligible for data analysis. Carotid MPRAGE-positive signal was associated with an acute cerebral territorial ischemic event with a relative risk of 6.4 (P<0.001). The relative risk of a diffusion tensor imaging-positive territorial ischemic event with carotid MPRAGE-positive signal was increased in mild, moderate, and severe stenosis categories (10.3, P<0.001; 2.9, P=0.01; and 2.2, P=0.01, respectively). Conclusions-In the workup of acute stroke, carotid MPRAGE-positive signal was associated with an increased risk of territorial cerebral ischemic events as detected objectively by brain diffusion tensor imaging. The relative risk of stroke was increased in all carotid stenosis categories but was most elevated in the mild stenosis category.",
author = "McNally, {J. Scott} and Kim, {Seong Eun} and Yoon, {Hyo Chun} and Laura Findeiss and Roberts, {John A.} and Nightingale, {Daniel R.} and Narra, {Krishna K.} and Parker, {Dennis L.} and Treiman, {Gerald S.}",
year = "2012",
month = "5",
day = "1",
doi = "10.1161/CIRCIMAGING.111.967398",
language = "English (US)",
volume = "5",
pages = "376--382",
journal = "Circulation: Cardiovascular Imaging",
issn = "1941-9651",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Carotid magnetization-prepared rapid acquisition with gradient-echo signal is associated with acute territorial cerebral ischemic events detected by diffusion-weighted MRI

AU - McNally, J. Scott

AU - Kim, Seong Eun

AU - Yoon, Hyo Chun

AU - Findeiss, Laura

AU - Roberts, John A.

AU - Nightingale, Daniel R.

AU - Narra, Krishna K.

AU - Parker, Dennis L.

AU - Treiman, Gerald S.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Background-Carotid intraplaque hemorrhage has been associated with symptomatic stroke and can be accurately detected with magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Currently, there are no studies analyzing carotid MPRAGE signal and territorial ischemic events defined by diffusion restriction in the acute setting. Our aim was to determine the association of carotid MPRAGE signal with acute territorial ischemic events using carotid MPRAGE and brain diffusion tensor imaging. Methods and Results-After the addition of the MPRAGE sequence to the neck MR angiographic protocol, 159 patients with suspected acute stroke were evaluated with both brain diffusion tensor imaging and carotid MPRAGE sequences over 2 years, providing 318 carotid artery and paired brain images for analysis. Forty-eight arteries were excluded due to extracarotid sources of brain ischemia and 4 were excluded due to carotid occlusion. Two hundred sixty-six arteries were eligible for data analysis. Carotid MPRAGE-positive signal was associated with an acute cerebral territorial ischemic event with a relative risk of 6.4 (P<0.001). The relative risk of a diffusion tensor imaging-positive territorial ischemic event with carotid MPRAGE-positive signal was increased in mild, moderate, and severe stenosis categories (10.3, P<0.001; 2.9, P=0.01; and 2.2, P=0.01, respectively). Conclusions-In the workup of acute stroke, carotid MPRAGE-positive signal was associated with an increased risk of territorial cerebral ischemic events as detected objectively by brain diffusion tensor imaging. The relative risk of stroke was increased in all carotid stenosis categories but was most elevated in the mild stenosis category.

AB - Background-Carotid intraplaque hemorrhage has been associated with symptomatic stroke and can be accurately detected with magnetization-prepared rapid acquisition with gradient-echo (MPRAGE). Currently, there are no studies analyzing carotid MPRAGE signal and territorial ischemic events defined by diffusion restriction in the acute setting. Our aim was to determine the association of carotid MPRAGE signal with acute territorial ischemic events using carotid MPRAGE and brain diffusion tensor imaging. Methods and Results-After the addition of the MPRAGE sequence to the neck MR angiographic protocol, 159 patients with suspected acute stroke were evaluated with both brain diffusion tensor imaging and carotid MPRAGE sequences over 2 years, providing 318 carotid artery and paired brain images for analysis. Forty-eight arteries were excluded due to extracarotid sources of brain ischemia and 4 were excluded due to carotid occlusion. Two hundred sixty-six arteries were eligible for data analysis. Carotid MPRAGE-positive signal was associated with an acute cerebral territorial ischemic event with a relative risk of 6.4 (P<0.001). The relative risk of a diffusion tensor imaging-positive territorial ischemic event with carotid MPRAGE-positive signal was increased in mild, moderate, and severe stenosis categories (10.3, P<0.001; 2.9, P=0.01; and 2.2, P=0.01, respectively). Conclusions-In the workup of acute stroke, carotid MPRAGE-positive signal was associated with an increased risk of territorial cerebral ischemic events as detected objectively by brain diffusion tensor imaging. The relative risk of stroke was increased in all carotid stenosis categories but was most elevated in the mild stenosis category.

UR - http://www.scopus.com/inward/record.url?scp=84863659476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863659476&partnerID=8YFLogxK

U2 - 10.1161/CIRCIMAGING.111.967398

DO - 10.1161/CIRCIMAGING.111.967398

M3 - Article

VL - 5

SP - 376

EP - 382

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

SN - 1941-9651

IS - 3

ER -