CONTRAST ENHANCED MRI IN THE ASSESSMENT OF THE RELATIONSHIPS OF ATHEROSCLEROTIC LESIONS OF CAROTID ARTERIES AND AORTIC WALL

Aim of the study. The relationships and connections of atherosclerotic damage of carotid arterial wall concomitant with atherosclerosis of thoracic aorta have been studied here, as from data of contrast-enhanced magnetic resonance imaging (MRI), and also bearing in mind the results of blood lipids biochemistry. Material and methods. The study patients group comprised seventeen persons (of which 12 males and five females, as old as 62.3 ± 6.2 years) with extensive atherosclerosis verified from data of complex radiologic and biochemical study. In everybody extensive MRI study with contrast enhancement has been carried out imaging both carotid, cerebral and aortic arch regions, and also blood spectrum of lipids was studied. Everybody used to be a in-patient of departments of cardiovascular surgery or of urgent cardiology, with multiple ischemic attacks in cerebral and coronary vascular areas (all seventeen) and also lower limb vascular arterial disorders (in twelve). Diabetes mellitus of type 2 with need of antidiabetic peroral treatment was present in eight of seventeen included. Carotid arterial stenotic atherosclerosis involved common carotid artery bifurcation and internal carotid artery (with bilateral critical stenosis in ten patients and with essentially monolateral one in seven patients) and was concomitant with stenosis over 50 % in one or more segment of syphone and/or intracranial part of internal carotid artery or of anterior or middle cerebral arteries. MRI study of aorta and carotid arteries has been carried out in everybody using MRI scanner with Toshiba Titan Vantage with field induction 1.5 T. Pearson’s parametric coefficient of correlation was employed for analysis of group relationships, with calculation of correlation coefficient r . Results. In all patients with atherosclerosis statistically significantly higher values of paramagnetic contrast enhancement of T1WI- SE scans of carotid artery’s wall as compared to the control group were observed. Age-matched control persons demonstrated the indices as low as 1.04 ± 0.02. In particular the index of enhancement of T1-WI of carotid arteries and aorta in patients with advanced atherosclerosis were as follows: over carotid arteries - 1.24 ± 0.17, over r aorta - 1.22 ± 0.17. When assessing the relationship between the indices of enhancement of T1-WI of aorta and of carotid arteries, a positive linear correlation was found ( r = 0.672, p < 0.05). There were no evidence for aortic dissection or aneurysm; the diameter of aorta in patients with atherosclerosis was as narrow as 2.5 ± 0.31 cm. The index of enhancement of T1-WI of carotid arteries atherosclerotic lesion and the total cholesterol level did correlate significantly ( r = 0.584, p < 0.05). There was also positive correlation between index of enhancement of T1-Scans of carotid plaque and blood triglycerides ( r = 0.667; p <0.05). Conclusion. Uptake of paramagnetic contrast agents as visual expression of pathologic neoangiogenesis in the media layers of wall of aorta and carotid arteries is seen over all extent of aortic arch and carotid vessels in patients with extensive atherosclerosis. When observing the uptake of paramagnetic contrast to the arterial wall concomitant with carotid stenosis it is recommended to carry out the MRI of aorta as well.

atherosclerosis, neovascularization, lipid profile, carotid arteries, aorta

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