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<meta name="DC.Title" content="Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6442" />
<meta name="DC.Date" content="2020-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2020 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions.

MATERIALS AND METHODS: Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed.

RESULTS: Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) ( P  = .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility.

CONCLUSIONS: In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications.

ECAA
:   extracranial carotid artery aneurysm
Gd
:   gadolinium
WML
:   white matter lesion
CAR
:   Carotid Aneurysm Registry" />
<meta name="DC.Contributor" content="C.J.H.C.M. van Laarhoven" />
<meta name="DC.Contributor" content="M.L. Rots" />
<meta name="DC.Contributor" content="V.E.C. Pourier" />
<meta name="DC.Contributor" content="N.K.N. Jorritsma" />
<meta name="DC.Contributor" content="T. Leiner" />
<meta name="DC.Contributor" content="J. Hendrikse" />
<meta name="DC.Contributor" content="M.D.I. Vergouwen" />
<meta name="DC.Contributor" content="G.J. de Borst" />
<meta name="article:published_time" content="2020-03-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) (&lt;i&gt;P &lt;/i&gt;= .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2020/03/01" />
<meta name="citation_mjid" content="ajnr;41/3/501" />
<meta name="citation_id" content="41/3/501" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_doi" content="10.3174/ajnr.A6442" />
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<meta name="citation_volume" content="41" />
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<meta name="citation_section" content="Extracranial Vascular" />
<meta name="citation_firstpage" content="501" />
<meta name="citation_lastpage" content="507" />
<meta name="citation_author" content="C.J.H.C.M. van Laarhoven" />
<meta name="citation_author_institution" content="aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8817-7315" />
<meta name="citation_author" content="M.L. Rots" />
<meta name="citation_author_institution" content="aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-3751-0376" />
<meta name="citation_author" content="V.E.C. Pourier" />
<meta name="citation_author_institution" content="aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)" />
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<meta name="citation_reference" content="citation_journal_title=Int J Stroke;citation_author=ACST-1 trial Collaborators;citation_title=Ten-year risk of stroke in patients with previous cerebral infarction and the impact of carotid surgery in the Asymptomatic Carotid Surgery Trial;citation_volume=11;citation_year=2016;citation_pmid=27435205;citation_doi=10.1177/1747493016660319" />
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<meta name="citation_reference" content="citation_journal_title=J Magn Reson Imaging;citation_author=H. Yang;citation_author=X. Zhang;citation_author=Q. Qin;citation_title=Improved cerebrospinal fluid suppression for intracranial vessel wall MRI;citation_pages=665-72;citation_volume=44;citation_year=2016;citation_pmid=26950926;citation_doi=10.1002/jmri.25211" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurology;citation_journal_abbrev=J Neurol;citation_author=F. de Leeuw;citation_author=J. de Groot;citation_author=M. Bots;citation_title=Carotid atherosclerosis and cerebral white matter lesions in a population based magnetic resonance imaging study.;citation_pages=291-296;citation_volume=247;citation_year=2000;citation_issue=4;citation_pmid=10836622;citation_doi=10.1007/s004150050586" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Roentgenology;citation_journal_abbrev=Am. J. Roentgenol.;citation_author=F. Fazekas;citation_author=JB. Chawluk;citation_author=A. Alavi;citation_title=MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging;citation_pages=351-356;citation_volume=149;citation_year=1987;citation_issue=2;citation_pmid=3496763;citation_doi=10.2214/ajr.149.2.351" />
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<meta name="citation_reference" content="citation_journal_title=Journal of clinical epidemiology;citation_journal_abbrev=J Clin Epidemiol;citation_author=HC. de Vet;citation_author=CB. Terwee;citation_author=DL. Knol;citation_title=When to use agreement versus reliability measures.;citation_pages=1033-1039;citation_volume=59;citation_year=2006;citation_issue=10;citation_pmid=16980142;citation_doi=10.1016/j.jclinepi.2005.10.015" />
<meta name="citation_reference" content="citation_journal_title=Journal of magnetic resonance imaging :  JMRI;citation_journal_abbrev=J Magn Reson Imaging;citation_author=S. Aoki;citation_author=K. Aoki;citation_author=S. Ohsawa;citation_title=Dynamic MR imaging of the carotid wall.;citation_pages=420-427;citation_volume=9;citation_year=1999;citation_issue=3;citation_pmid=10194712;citation_doi=10.1002/(SICI)1522-2586(199903)9:3&lt;420::AID-JMRI9&gt;3.0.CO;2-D" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=Y. Qiao;citation_author=M. Etesami;citation_author=BC. Astor;citation_title=Carotid plaque neovascularization and hemorrhage detected by MR imaging are associated with recent cerebrovascular ischemic events;citation_volume=33;citation_year=2012;citation_pmid=22194363;citation_doi=10.3174/ajnr.A2863" />
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<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=MD. Vergouwen;citation_author=D. Backes;citation_author=IC. van der Schaaf;citation_title=Gadolinium enhancement of the aneurysm wall in unruptured intracranial aneurysms is associated with an increased risk of aneurysm instability: a follow-up study;citation_pages=111-16;citation_volume=40;citation_year=2019;citation_pmid=31221634;citation_doi=10.3174/ajnr.A6105" />
<meta name="citation_reference" content="citation_journal_abbrev=Nat Rev Neurol;citation_author=T. Krings;citation_author=DM. Mandell;citation_author=TR. Kiehl;citation_title=Intracranial aneurysms: from vessel wall pathology to therapeutic approach.;citation_pages=547-559;citation_volume=7;citation_year=2011;citation_issue=10;citation_pmid=21931350;citation_doi=10.1038/nrneurol.2011.136" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_journal_abbrev=Radiology;citation_author=A. Portanova;citation_author=N. Hakakian;citation_author=DJ. Mikulis;citation_title=Intracranial Vasa Vasorum: Insights and Implications for Imaging;citation_pages=667-679;citation_volume=267;citation_year=2013;citation_issue=3;citation_pmid=23704290;citation_doi=10.1148/radiol.13112310" />
<meta name="citation_reference" content="citation_journal_title=Cerebrovascular diseases (Basel, Switzerland);citation_journal_abbrev=Cerebrovasc Dis;citation_author=GM. Potter;citation_author=FN. Doubal;citation_author=CA. Jackson;citation_title=Lack of association of white matter lesions with ipsilateral carotid artery stenosis.;citation_pages=378-384;citation_volume=33;citation_year=2012;citation_issue=4;citation_pmid=22433285;citation_doi=10.1159/000336762" />
<meta name="citation_reference" content="citation_journal_title=Journal of Neurology, Neurosurgery &amp; Psychiatry;citation_journal_abbrev=J. Neurol. Neurosurg. Psychiatry;citation_author=FE. Leeuw;citation_author=JC. De Groot;citation_author=E. De Achten;citation_title=Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study;citation_pages=9-14;citation_volume=70;citation_year=2001;citation_issue=1;citation_pmid=11118240;citation_doi=10.1136/jnnp.70.1.9" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=EJ. Van Dijk;citation_author=ND. Prins;citation_author=HA. Vrooman;citation_title=Progression of cerebral small vessel disease in relation to risk factors and cognitive consequences: Rotterdam Scan Study;citation_volume=39;citation_year=2008;citation_pmid=18635849;citation_doi=10.1161/STROKEAHA.107.513176" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=North American Symptomatic Carotid Endarterectomy Trial Group;citation_title=Prognostic Importance of Leukoaraiosis in Patients With Symptomatic Internal Carotid Artery Stenosis;citation_pages=1651-1655;citation_volume=33;citation_year=2002;citation_issue=6;citation_pmid=12053006;citation_doi=10.1161/01.STR.0000018010.38749.08" />
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<meta name="twitter:title" content="Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions.

MATERIALS AND METHODS: Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed.

RESULTS: Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) ( P  = .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility.

CONCLUSIONS: In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications.

ECAA
:   extracranial carotid artery aneurysm
Gd
:   gadolinium
WML
:   white matter lesion
CAR
:   Carotid Aneurysm Registry" />
<meta name="og-title" property="og:title" content="Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/41/3/501" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions.

MATERIALS AND METHODS: Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed.

RESULTS: Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) ( P  = .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility.

CONCLUSIONS: In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications.

ECAA
:   extracranial carotid artery aneurysm
Gd
:   gadolinium
WML
:   white matter lesion
CAR
:   Carotid Aneurysm Registry" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node73856--5" data-node-nid="73856" id="top-node-73856--6739530831" data-pisa="ajnr;41/3/501" data-pisa-master="ajnr;ajnr.A6442" data-apath="/ajnr/41/3/501.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Extracranial Vascular</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">C.J.H.C.M. van Laarhoven</span>, <span class="highwire-citation-author" data-delta="1">M.L. Rots</span>, <span class="highwire-citation-author" data-delta="2">V.E.C. Pourier</span>, <span class="highwire-citation-author" data-delta="3">N.K.N. Jorritsma</span>, <span class="highwire-citation-author" data-delta="4">T. Leiner</span>, <span class="highwire-citation-author" data-delta="5">J. Hendrikse</span>, <span class="highwire-citation-author" data-delta="6">M.D.I. Vergouwen</span> and <span class="highwire-citation-author" data-delta="7">G.J. de Borst</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">501-507; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6442 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-73856--6739530831" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">C.J.H.C.M. van Laarhoven </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.J.H.C.M.%2Bvan%2BLaarhoven%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=van%20Laarhoven%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.J.H.C.M.%2Bvan%2BLaarhoven%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8817-7315" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.J.H.C.M. van Laarhoven</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.L. Rots </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.L.%2BRots%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rots%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.L.%2BRots%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3751-0376" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.L. Rots</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">V.E.C. Pourier </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.E.C.%2BPourier%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pourier%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AV.E.C.%2BPourier%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4766-8289" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V.E.C. Pourier</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">N.K.N. Jorritsma </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.K.N.%2BJorritsma%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jorritsma%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.K.N.%2BJorritsma%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4583-0051" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.K.N. Jorritsma</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">T. Leiner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (T.L., J.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BLeiner%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Leiner%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BLeiner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1885-5499" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. Leiner</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">J. Hendrikse </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (T.L., J.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BHendrikse%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hendrikse%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BHendrikse%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6384-6140" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Hendrikse</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">M.D.I. Vergouwen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>UMC Utrecht Brain Center (M.D.I.V.), Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.D.I.%2BVergouwen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vergouwen%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.D.I.%2BVergouwen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6823-1628" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.D.I. Vergouwen</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">G.J. de Borst </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.J.%2Bde%2BBorst%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=de%20Borst%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.J.%2Bde%2BBorst%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1389-4141" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G.J. de Borst</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) (<em>P </em>= .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility.</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">ECAA<span class="def-item-dt-sep"></span></dt><dd>extracranial carotid artery aneurysm<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">Gd<span class="def-item-dt-sep"></span></dt><dd>gadolinium<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">WML<span class="def-item-dt-sep"></span></dt><dd>white matter lesion<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CAR<span class="def-item-dt-sep"></span></dt><dd>Carotid Aneurysm Registry</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2020 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/41/3/501.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">501-507; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6442 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">C.J.H.C.M.</span> <span class="nlm-surname">van Laarhoven</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.L.</span> <span class="nlm-surname">Rots</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">V.E.C.</span> <span class="nlm-surname">Pourier</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">N.K.N.</span> <span class="nlm-surname">Jorritsma</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Leiner</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Hendrikse</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">M.D.I.</span> <span class="nlm-surname">Vergouwen</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">G.J.</span> <span class="nlm-surname">de Borst</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">501-507; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6442 </span></div>
  
  
  
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