Detection of unstable carotid artery stenosis using MRI

L. Esposito, M. Sievers, D. Sander, P. Heider, O. Wolf, O. Greil, C. Zimmer, H. Poppert

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background and purpose: Carotid artery stenosis can be classified by magnetic resonance imaging (MRI) as lesion types I-VIII according to a modified histological scheme based on American Heart Association (AHA) guidelines. Lesion types IV-V and VI are regarded as high-risk plaques.We aimed to evaluate the clinical relevance of this classification for identifying unstable plaques. Methods: Eighty-five patients (29 female) with severe carotid artery stenosis (diagnosed by Doppler and duplex ultrasonography) were imaged using a 1.5 T scanner with bilateral phased-array carotid coils. T1-, T2-, time-offlight (TOF) and proton-density (PD)-weighted studies were obtained. The carotid plaques were classified as lesion types III-VIII according to the MRI-modified AHA criteria. Results: Thirty-five patients presented with a recently symptomatic stenosis; 50 patients were asymptomatic. Lesion types IV-V (51.4 % vs. 22 %) and VI (20 % vs. 4%; P < 0.0001) were found significantly more often in symptomatic patients compared to those without a history of cerebral ischemia. Conclusions: The distribution of lesion types differs significantly between symptomatic and asymptomatic carotid artery stenosis. High-risk lesion types IV-V and VI were overrepresented in recently symptomatic patients. MRI according to the modified AHA-criteria may be a suitable tool for detection of unstable carotid lesions.

Original languageEnglish
Pages (from-to)1714-1722
Number of pages9
JournalJournal of Neurology
Issue number12
StatePublished - Dec 2007
Externally publishedYes


  • Carotid artery stenosis
  • Magnetic resonance imaging
  • Plaque


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