The annual progression of carotid wall volume is independently associated with recurrent ischemic cerebrovascular events, and this measurement has added value for intraplaque hemorrhage and fibrous cap rupture in predicting future events.

Aim: The present study aimed to investigate the association between shape and location of atherosclerotic plaques and intraplaque hemorrhage (IPH) in carotid arteries using magnetic resonance (MR) imaging. Methods: Overall, 114 symptomatic patients (mean age: 64.9±10.9 years; 81 males) who underwent MR imaging and had advanced carotid plaques were included in analysis. IPH presence and carotid plaque shape and location (below and above bifurcation) were evaluated. The plaque shape was defined as follows: type-I: the arc-length of plaque is greater in the upstream; type-II: the arc-length of plaque in downstream and upstream is equal; and type-III: the arc-length of plaque is greater in downstream. The plaque shape and location were compared between plaques with and without IPH and their associations with IPH were determined. Results: Of 181detectedplaques, 57 (31.5%) had IPH. Compared with plaques without IPH, those with IPH had higher incidence of the plaque shape of type-I (66.7% vs. 32.2%, P <0.001), lower incidence of plaque shape of type-III (24.6% vs. 50.0%, P =0.001), and were more likely located above carotid bifurcation (71.9% vs. 48.4%, P =0.003). The plaque shape of type-I (OR, 4.01; 95%CI, 1.36–11.83; P =0.012) and location above bifurcation (OR, 3.21; 95%CI, 1.07–9.61; P =0.037) of carotid plaques were significantly associated with IPH after adjusting for confounder factors. Conclusions: Carotid plaque shape and location are significantly associated with the occurrence of IPH. Our findings could provide new insights for the pathogenesis of IPH and vulnerably plaques.

Aim: To investigate the association between the volumes of different aging intraplaque hemorrhage (IPH) and minor fibrous cap disruption (MFCD) in carotid arteries.Methods: Patients with cerebrovascular symptoms and carotid atherosclerotic plaques determined by ultrasound were recruited and underwent multi-contrast magnetic resonance (MR) vessel wall imaging for carotid arteries. Carotid plaques with IPH on MR imaging were included in the analysis. The age (fresh or recent) and the volume of IPH for each plaque were evaluated.Results: In total, 41 carotid plaques in 37 patients (mean age 70.2 ± 11.0 years old; 32 males) were eligible for statistical analysis. The absolute volume of fresh IPH in plaques with MFCD was significantly larger than that in plaques without MFCD (109.83 ± 75.49 mm3 vs. 30.54 ± 20.62 mm3, P = 0.002). Logistic regression showed that the absolute volume of fresh IPH was significantly associated with MFCD before (odds ratio [OR], 1.735; 95% confidence interval [CI], 1.127–2.670; P = 0.012) and after adjusting for confounding factors (OR, 1.823; 95% CI, 1.076–3.090; P = 0.026). There was no significant association between recent IPH volume and MFCD (P > 0.05).Conclusion: The volume of fresh IPH is independently associated with MFCD in carotid plaques, suggesting that integrity of fibrous cap may change with different age and size of IPH.