Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus
Abstract Background Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between...
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doaj-af1636841673446bab3254bf3e9d0a5e2020-11-24T21:36:35ZengBMCCardiovascular Diabetology1475-28402017-09-011611910.1186/s12933-017-0592-9Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitusBeibei Sun0Xiao Li1Xiaosheng Liu2Xiaoqian Ge3Qing Lu4Xihai Zhao5Jun Pu6Jianrong Xu7Huilin Zhao8Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityCenter for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of MedicineDepartment of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong UniversityAbstract Background Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between carotid plaque characteristics and acute cerebral infarct (ACI) lesion features determined by MRI in T2DM patients. Methods Patients with acute cerebrovascular syndrome in internal carotid artery territory were recruited. All patients were stratified into T2DM and non-T2DM groups and underwent both carotid and brain MRI scans. Ipsilateral carotid plaque morphological and compositional characteristics, intracranial and extracranial carotid artery stenosis were also determined. Stroke subtype based on the Trial of ORG 10172 in Acute Stroke Treatment classification and ACI lesion patterns were evaluated. Results Of the recruited 140 patients, 68 (48.6%) patients had T2DM (mean age 64.16 ± 11.38 years, 40 males). T2DM patients exhibited higher prevalence of carotid type IV–VI lesions, larger plaque burden as well as larger lipid-rich necrotic core (LRNC) compared with non-T2DM patients. Among the patients with carotid LRNC on symptomatic side, more concomitant large perforating artery infarct patterns and larger ACI size in the internal carotid artery territory were found in T2DM group than those in non-T2DM group. Carotid plaque with LRNC% > 22.0% was identified as an independent risk factor for the presence of ACI lesions confined to the carotid territory in T2DM patients, regardless of other risk factors. Conclusions This study shows that more concomitant large perforating artery infarct patterns and larger ACI size in the internal carotid artery territory were found in the T2DM patients with ipsilateral carotid LRNC plaque than those in non-T2DM patients. Quantification of the carotid plaque characteristics, particularly the LRNC% by MRI has the potential usefulness for stroke risk stratification.http://link.springer.com/article/10.1186/s12933-017-0592-9Diabetes mellitusAcute strokeCarotid plaqueLipid-rich necrotic coreMR imaging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Beibei Sun Xiao Li Xiaosheng Liu Xiaoqian Ge Qing Lu Xihai Zhao Jun Pu Jianrong Xu Huilin Zhao |
spellingShingle |
Beibei Sun Xiao Li Xiaosheng Liu Xiaoqian Ge Qing Lu Xihai Zhao Jun Pu Jianrong Xu Huilin Zhao Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus Cardiovascular Diabetology Diabetes mellitus Acute stroke Carotid plaque Lipid-rich necrotic core MR imaging |
author_facet |
Beibei Sun Xiao Li Xiaosheng Liu Xiaoqian Ge Qing Lu Xihai Zhao Jun Pu Jianrong Xu Huilin Zhao |
author_sort |
Beibei Sun |
title |
Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus |
title_short |
Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus |
title_full |
Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus |
title_fullStr |
Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus |
title_full_unstemmed |
Association between carotid plaque characteristics and acute cerebral infarction determined by MRI in patients with type 2 diabetes mellitus |
title_sort |
association between carotid plaque characteristics and acute cerebral infarction determined by mri in patients with type 2 diabetes mellitus |
publisher |
BMC |
series |
Cardiovascular Diabetology |
issn |
1475-2840 |
publishDate |
2017-09-01 |
description |
Abstract Background Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between carotid plaque characteristics and acute cerebral infarct (ACI) lesion features determined by MRI in T2DM patients. Methods Patients with acute cerebrovascular syndrome in internal carotid artery territory were recruited. All patients were stratified into T2DM and non-T2DM groups and underwent both carotid and brain MRI scans. Ipsilateral carotid plaque morphological and compositional characteristics, intracranial and extracranial carotid artery stenosis were also determined. Stroke subtype based on the Trial of ORG 10172 in Acute Stroke Treatment classification and ACI lesion patterns were evaluated. Results Of the recruited 140 patients, 68 (48.6%) patients had T2DM (mean age 64.16 ± 11.38 years, 40 males). T2DM patients exhibited higher prevalence of carotid type IV–VI lesions, larger plaque burden as well as larger lipid-rich necrotic core (LRNC) compared with non-T2DM patients. Among the patients with carotid LRNC on symptomatic side, more concomitant large perforating artery infarct patterns and larger ACI size in the internal carotid artery territory were found in T2DM group than those in non-T2DM group. Carotid plaque with LRNC% > 22.0% was identified as an independent risk factor for the presence of ACI lesions confined to the carotid territory in T2DM patients, regardless of other risk factors. Conclusions This study shows that more concomitant large perforating artery infarct patterns and larger ACI size in the internal carotid artery territory were found in the T2DM patients with ipsilateral carotid LRNC plaque than those in non-T2DM patients. Quantification of the carotid plaque characteristics, particularly the LRNC% by MRI has the potential usefulness for stroke risk stratification. |
topic |
Diabetes mellitus Acute stroke Carotid plaque Lipid-rich necrotic core MR imaging |
url |
http://link.springer.com/article/10.1186/s12933-017-0592-9 |
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