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<meta name="DC.Title" content="Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6498" />
<meta name="DC.Date" content="2020-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2020 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Identifying the mere presence of carotid intraplaque hemorrhage would be insufficient to accurately discriminate the presence of acute cerebral infarct. We aimed to investigate the association between signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted MR imaging and acute cerebral infarct in patients with hemorrhagic carotid plaques using MR vessel wall imaging.

MATERIALS AND METHODS: Symptomatic patients with carotid intraplaque hemorrhage were included. The signal intensity ratios of carotid intraplaque hemorrhage against muscle on T1-weighted, TOF, and MPRAGE images were measured. The acute cerebral infarct was determined on the hemisphere ipsilateral to the carotid intraplaque hemorrhage. The association between signal intensity ratios of carotid intraplaque hemorrhage and acute cerebral infarct was analyzed.

RESULTS: Of 109 included patients (mean, 66.8 ± 9.9 years of age; 96 men), 40 (36.7%) had acute cerebral infarct. Patients with acute cerebral infarct had significantly higher signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted images than those without (Median, 1.44; 25–75 Percentiles, 1.14-1.82 versus Median, 1.27; 25–75 Percentiles, 1.06–1.55, P = .022). Logistic regression analysis revealed that the signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images was significantly associated with acute cerebral infarct before (OR, 4.08; 95% CI, 1.34–12.40; P = .013) and after (OR, 3.34; 95% CI, 1.08–10.31; P = .036) adjustment for clinical confounding factors. However, this association was not significant when further adjusted for occlusion of the carotid artery ( P = .058) and volumes of intraplaque hemorrhage and lipid-rich necrotic core ( P = .458).

CONCLUSIONS: The signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images is associated with acute cerebral infarct in symptomatic patients with carotid hemorrhagic plaques. This association is independent of traditional risk factors but not of the size of plaque composition. The possibility of applying T1 signals of carotid intraplaque hemorrhage to predict subsequent cerebrovascular ischemic events needs to be prospectively verified.

ACI
:   acute cerebral infarct
IPH
:   intraplaque hemorrhage
LRNC
:   lipid-rich necrotic core
SIR
:   signal intensity ratio" />
<meta name="DC.Contributor" content="D. Yang" />
<meta name="DC.Contributor" content="Y. Liu" />
<meta name="DC.Contributor" content="Y. Han" />
<meta name="DC.Contributor" content="D. Li" />
<meta name="DC.Contributor" content="W. Wang" />
<meta name="DC.Contributor" content="R. Li" />
<meta name="DC.Contributor" content="C. Yuan" />
<meta name="DC.Contributor" content="X. Zhao" />
<meta name="article:published_time" content="2020-05-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Identifying the mere presence of carotid intraplaque hemorrhage would be insufficient to accurately discriminate the presence of acute cerebral infarct. We aimed to investigate the association between signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted MR imaging and acute cerebral infarct in patients with hemorrhagic carotid plaques using MR vessel wall imaging.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Symptomatic patients with carotid intraplaque hemorrhage were included. The signal intensity ratios of carotid intraplaque hemorrhage against muscle on T1-weighted, TOF, and MPRAGE images were measured. The acute cerebral infarct was determined on the hemisphere ipsilateral to the carotid intraplaque hemorrhage. The association between signal intensity ratios of carotid intraplaque hemorrhage and acute cerebral infarct was analyzed.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of 109 included patients (mean, 66.8 ± 9.9 years of age; 96 men), 40 (36.7%) had acute cerebral infarct. Patients with acute cerebral infarct had significantly higher signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted images than those without (Median, 1.44; 25–75 Percentiles, 1.14-1.82 versus Median, 1.27; 25–75 Percentiles, 1.06–1.55, &lt;i&gt;P&lt;/i&gt; = .022). Logistic regression analysis revealed that the signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images was significantly associated with acute cerebral infarct before (OR, 4.08; 95% CI, 1.34–12.40; &lt;i&gt;P&lt;/i&gt; = .013) and after (OR, 3.34; 95% CI, 1.08–10.31; &lt;i&gt;P&lt;/i&gt; = .036) adjustment for clinical confounding factors. However, this association was not significant when further adjusted for occlusion of the carotid artery (&lt;i&gt;P&lt;/i&gt; = .058) and volumes of intraplaque hemorrhage and lipid-rich necrotic core (&lt;i&gt;P&lt;/i&gt; = .458).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images is associated with acute cerebral infarct in symptomatic patients with carotid hemorrhagic plaques. This association is independent of traditional risk factors but not of the size of plaque composition. The possibility of applying T1 signals of carotid intraplaque hemorrhage to predict subsequent cerebrovascular ischemic events needs to be prospectively verified.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2020/05/01" />
<meta name="citation_mjid" content="ajnr;41/5/836" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A6498" />
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<meta name="citation_volume" content="41" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Extracranial Vascular" />
<meta name="citation_firstpage" content="836" />
<meta name="citation_lastpage" content="843" />
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<meta name="citation_author" content="D. Yang" />
<meta name="citation_author_institution" content="aFrom the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China" />
<meta name="citation_author_institution" content="bDepartment of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6528-0846" />
<meta name="citation_author" content="Y. Liu" />
<meta name="citation_author_institution" content="cDepartment of Radiology (Y.L., W.W.), The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-0650-0036" />
<meta name="citation_author" content="Y. Han" />
<meta name="citation_author_institution" content="aFrom the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China" />
<meta name="citation_author_institution" content="bDepartment of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-6207-8987" />
<meta name="citation_author" content="D. Li" />
<meta name="citation_author_institution" content="aFrom the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China" />
<meta name="citation_author_institution" content="bDepartment of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-5272-1473" />
<meta name="citation_author" content="W. Wang" />
<meta name="citation_author_institution" content="cDepartment of Radiology (Y.L., W.W.), The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-4345-1608" />
<meta name="citation_author" content="R. Li" />
<meta name="citation_author_institution" content="bDepartment of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-6258-8258" />
<meta name="citation_author" content="C. Yuan" />
<meta name="citation_author_institution" content="dDepartment of Radiology (C.Y.), University of Washington, Seattle, Washington." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6154-5106" />
<meta name="citation_author" content="X. Zhao" />
<meta name="citation_author_institution" content="bDepartment of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China" />
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<meta name="twitter:title" content="Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Identifying the mere presence of carotid intraplaque hemorrhage would be insufficient to accurately discriminate the presence of acute cerebral infarct. We aimed to investigate the association between signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted MR imaging and acute cerebral infarct in patients with hemorrhagic carotid plaques using MR vessel wall imaging.

MATERIALS AND METHODS: Symptomatic patients with carotid intraplaque hemorrhage were included. The signal intensity ratios of carotid intraplaque hemorrhage against muscle on T1-weighted, TOF, and MPRAGE images were measured. The acute cerebral infarct was determined on the hemisphere ipsilateral to the carotid intraplaque hemorrhage. The association between signal intensity ratios of carotid intraplaque hemorrhage and acute cerebral infarct was analyzed.

RESULTS: Of 109 included patients (mean, 66.8 ± 9.9 years of age; 96 men), 40 (36.7%) had acute cerebral infarct. Patients with acute cerebral infarct had significantly higher signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted images than those without (Median, 1.44; 25–75 Percentiles, 1.14-1.82 versus Median, 1.27; 25–75 Percentiles, 1.06–1.55, P = .022). Logistic regression analysis revealed that the signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images was significantly associated with acute cerebral infarct before (OR, 4.08; 95% CI, 1.34–12.40; P = .013) and after (OR, 3.34; 95% CI, 1.08–10.31; P = .036) adjustment for clinical confounding factors. However, this association was not significant when further adjusted for occlusion of the carotid artery ( P = .058) and volumes of intraplaque hemorrhage and lipid-rich necrotic core ( P = .458).

CONCLUSIONS: The signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images is associated with acute cerebral infarct in symptomatic patients with carotid hemorrhagic plaques. This association is independent of traditional risk factors but not of the size of plaque composition. The possibility of applying T1 signals of carotid intraplaque hemorrhage to predict subsequent cerebrovascular ischemic events needs to be prospectively verified.

ACI
:   acute cerebral infarct
IPH
:   intraplaque hemorrhage
LRNC
:   lipid-rich necrotic core
SIR
:   signal intensity ratio" />
<meta name="og-title" property="og:title" content="Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/41/5/836" />
<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: Identifying the mere presence of carotid intraplaque hemorrhage would be insufficient to accurately discriminate the presence of acute cerebral infarct. We aimed to investigate the association between signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted MR imaging and acute cerebral infarct in patients with hemorrhagic carotid plaques using MR vessel wall imaging.

MATERIALS AND METHODS: Symptomatic patients with carotid intraplaque hemorrhage were included. The signal intensity ratios of carotid intraplaque hemorrhage against muscle on T1-weighted, TOF, and MPRAGE images were measured. The acute cerebral infarct was determined on the hemisphere ipsilateral to the carotid intraplaque hemorrhage. The association between signal intensity ratios of carotid intraplaque hemorrhage and acute cerebral infarct was analyzed.

RESULTS: Of 109 included patients (mean, 66.8 ± 9.9 years of age; 96 men), 40 (36.7%) had acute cerebral infarct. Patients with acute cerebral infarct had significantly higher signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted images than those without (Median, 1.44; 25–75 Percentiles, 1.14-1.82 versus Median, 1.27; 25–75 Percentiles, 1.06–1.55, P = .022). Logistic regression analysis revealed that the signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images was significantly associated with acute cerebral infarct before (OR, 4.08; 95% CI, 1.34–12.40; P = .013) and after (OR, 3.34; 95% CI, 1.08–10.31; P = .036) adjustment for clinical confounding factors. However, this association was not significant when further adjusted for occlusion of the carotid artery ( P = .058) and volumes of intraplaque hemorrhage and lipid-rich necrotic core ( P = .458).

CONCLUSIONS: The signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images is associated with acute cerebral infarct in symptomatic patients with carotid hemorrhagic plaques. This association is independent of traditional risk factors but not of the size of plaque composition. The possibility of applying T1 signals of carotid intraplaque hemorrhage to predict subsequent cerebrovascular ischemic events needs to be prospectively verified.

ACI
:   acute cerebral infarct
IPH
:   intraplaque hemorrhage
LRNC
:   lipid-rich necrotic core
SIR
:   signal intensity ratio" />
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      <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">Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">D. Yang</span>, <span class="highwire-citation-author" data-delta="1">Y. Liu</span>, <span class="highwire-citation-author" data-delta="2">Y. Han</span>, <span class="highwire-citation-author" data-delta="3">D. Li</span>, <span class="highwire-citation-author" data-delta="4">W. Wang</span>, <span class="highwire-citation-author" data-delta="5">R. Li</span>, <span class="highwire-citation-author" data-delta="6">C. Yuan</span> and <span class="highwire-citation-author" data-delta="7">X. Zhao</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">May 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">836-843; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6498 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-75140--61127567823" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">D. Yang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China</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=D.%2BYang%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=Yang%20D&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%3AD.%2BYang%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/0000-0002-6528-0846" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Yang</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Y. Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (Y.L., W.W.), The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China</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=Y.%2BLiu%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=Liu%20Y&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%3AY.%2BLiu%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/0000-0002-0650-0036" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Liu</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Y. Han </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China</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=Y.%2BHan%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=Han%20Y&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%3AY.%2BHan%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/0000-0001-6207-8987" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Han</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">D. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Beijing Institute of Brain Disorders (D.Y., Y.H., D.L.), Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China</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=D.%2BLi%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=Li%20D&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%3AD.%2BLi%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/0000-0001-5272-1473" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Li</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">W. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (Y.L., W.W.), The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China</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=W.%2BWang%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=Wang%20W&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%3AW.%2BWang%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/0000-0002-4345-1608" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W. Wang</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">R. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China</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=R.%2BLi%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=Li%20R&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%3AR.%2BLi%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/0000-0001-6258-8258" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Li</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C. Yuan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (C.Y.), University of Washington, Seattle, Washington.</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.%2BYuan%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=Yuan%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.%2BYuan%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/0000-0002-6154-5106" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Yuan</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">X. Zhao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Biomedical Engineering (D.Y., Y.H., D.L., R.L., X.Z.), Center for Biomedical Imaging Research, Tsinghua University School of Medicine, Beijing, China</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=X.%2BZhao%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=Zhao%20X&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%3AX.%2BZhao%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/0000-0001-8953-0566" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. 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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-3"><strong>BACKGROUND AND PURPOSE:</strong> Identifying the mere presence of carotid intraplaque hemorrhage would be insufficient to accurately discriminate the presence of acute cerebral infarct. We aimed to investigate the association between signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted MR imaging and acute cerebral infarct in patients with hemorrhagic carotid plaques using MR vessel wall imaging.</p></div><div id="sec-2" class="subsection"><p id="p-4"><strong>MATERIALS AND METHODS:</strong> Symptomatic patients with carotid intraplaque hemorrhage were included. The signal intensity ratios of carotid intraplaque hemorrhage against muscle on T1-weighted, TOF, and MPRAGE images were measured. The acute cerebral infarct was determined on the hemisphere ipsilateral to the carotid intraplaque hemorrhage. The association between signal intensity ratios of carotid intraplaque hemorrhage and acute cerebral infarct was analyzed.</p></div><div id="sec-3" class="subsection"><p id="p-5"><strong>RESULTS:</strong> Of 109 included patients (mean, 66.8 ± 9.9 years of age; 96 men), 40 (36.7%) had acute cerebral infarct. Patients with acute cerebral infarct had significantly higher signal intensity ratios of carotid intraplaque hemorrhage on T1-weighted images than those without (Median, 1.44; 25–75 Percentiles, 1.14-1.82 versus Median, 1.27; 25–75 Percentiles, 1.06–1.55, <em>P</em> = .022). Logistic regression analysis revealed that the signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images was significantly associated with acute cerebral infarct before (OR, 4.08; 95% CI, 1.34–12.40; <em>P</em> = .013) and after (OR, 3.34; 95% CI, 1.08–10.31; <em>P</em> = .036) adjustment for clinical confounding factors. However, this association was not significant when further adjusted for occlusion of the carotid artery (<em>P</em> = .058) and volumes of intraplaque hemorrhage and lipid-rich necrotic core (<em>P</em> = .458).</p></div><div id="sec-4" class="subsection"><p id="p-6"><strong>CONCLUSIONS:</strong> The signal intensity ratio of carotid intraplaque hemorrhage on T1-weighted images is associated with acute cerebral infarct in symptomatic patients with carotid hemorrhagic plaques. This association is independent of traditional risk factors but not of the size of plaque composition. The possibility of applying T1 signals of carotid intraplaque hemorrhage to predict subsequent cerebrovascular ischemic events needs to be prospectively verified.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">ACI<span class="def-item-dt-sep"></span></dt><dd>acute cerebral infarct<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">IPH<span class="def-item-dt-sep"></span></dt><dd>intraplaque hemorrhage<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">LRNC<span class="def-item-dt-sep"></span></dt><dd>lipid-rich necrotic core<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">SIR<span class="def-item-dt-sep"></span></dt><dd>signal intensity ratio</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2020 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-2">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/41/5/836.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-volume highwire-cite-metadata">Vol. 41</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 5 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 May 2020 </div></div>
      
      
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      <div class="highwire-cite-title">Signal of Carotid Intraplaque Hemorrhage on MR T1-Weighted Imaging: Association with Acute Cerebral Infarct</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Yang</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Liu</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Han</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Li</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">W.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Li</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Yuan</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Zhao</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">836-843; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6498 </span></div>
  
  
  
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