J. Kevin DeMarco
Carotid plaque MRI has the ability to noninvasively detect “vulnerable plaque” features such as intraplaque hemorrhage, thin/ruptured fibrous cap, and large lipid-rich necrotic core, which may offer improved prediction of ispilateral carotid stroke or TIA compared with simple carotid stenosis measurements. Our work at Michigan State University has confirmed the ability of carotid plaque MR imaging to identify features associated with recent ipsilateral stroke/TIA, most notably in patients with only moderate stenosis. With the help of our research fellow Hideki Ota, and in collaboration with Chun Yuan at the Vascular Imaging Lab at the University of Washington, we have been able to publish multiple studies confirming the ability of our plaque hemorrhage sequence to accurately identify hemorrhage seen on histologic evaluation of carotid endarterectomy specimens, as well as a very interesting observation that men tend to harbor more of these “vulnerable plaque” features when compared with women.
Our MSU clinicians and those in the surrounding community have responded very favorably to this research. They actively encourage their patients to participate in our ongoing research and include a discussion of the carotid plaque MR findings with their patients. The clinicians find our research carotid plaque MR images useful in determining the optimal clinical treatment. The Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program issued an evidence-based set of guidelines on cholesterol management in 2001, including achieving LDL-C level of <100 mg/dL in patients with highest risk of future coronary heart