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<meta name="DC.Title" content="Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6868" />
<meta name="DC.Date" content="2021-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 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: Plaque ulceration is a marker of previous plaque rupture. We studied the association between atherosclerotic plaque composition at baseline and plaque ulceration at baseline and follow-up.

MATERIALS AND METHODS: We included symptomatic patients with a carotid stenosis of &lt;70% who underwent MDCTA and MR imaging at baseline ( n  = 180). MDCTA was repeated at 2 years ( n  = 73). We assessed the presence of ulceration using MDCTA. Baseline MR imaging was used to assess the vessel wall volume and the presence and volume of plaque components (intraplaque hemorrhage, lipid-rich necrotic core, and calcifications) and the fibrous cap status. Associations at baseline were evaluated with binary logistic regression and reported with an OR and its 95% CI. Simple statistical testing was performed in the follow-up analysis.

RESULTS: At baseline, the prevalence of plaque ulceration was 27% (49/180). Increased wall volume (OR  = 12.1; 95% CI, 3.5–42.0), higher relative lipid-rich necrotic core (OR = 1.7; 95% CI, 1.3–2.2), higher relative intraplaque hemorrhage volume (OR = 1.7; 95% CI, 1.3–2.2), and a thin-or-ruptured fibrous cap (OR = 3.4; 95% CI, 1.7–6.7) were associated with the presence of ulcerations at baseline. In 8% (6/73) of the patients, a new ulcer developed. Plaques with a new ulceration at follow-up had at baseline a larger wall volume (1.04 cm3 [IQR, 0.97–1.16 cm3] versus 0.86 cm3 [IQR, 0.73–1.00 cm3]; P  = .029), a larger relative lipid-rich necrotic core volume (23% [IQR, 13–31%] versus 2% [IQR, 0–14%]; P  = .002), and a larger relative intraplaque hemorrhage volume (14% [IQR, 8–24%] versus 0% [IQR, 0–5%]; P  &lt; .001).

CONCLUSIONS: Large atherosclerotic plaques and plaques with intraplaque hemorrhage and lipid-rich necrotic cores were associated with plaque ulcerations at baseline and follow-up.

AUC
:   area under the curve
IPH
:   intraplaque hemorrhage
IQR
:   interquartile range
LRNC
:   lipid-rich necrotic core
TRFC
:   thick versus thin-or-ruptured fibrous cap" />
<meta name="DC.Contributor" content="K. Dilba" />
<meta name="DC.Contributor" content="D.H.K. van Dam-Nolen" />
<meta name="DC.Contributor" content="A.C. van Dijk" />
<meta name="DC.Contributor" content="M. Kassem" />
<meta name="DC.Contributor" content="A.F.W. van der Steen" />
<meta name="DC.Contributor" content="P.J. Koudstaal" />
<meta name="DC.Contributor" content="P.J. Nederkoorn" />
<meta name="DC.Contributor" content="J. Hendrikse" />
<meta name="DC.Contributor" content="M.E. Kooi" />
<meta name="DC.Contributor" content="J.J. Wentzel" />
<meta name="DC.Contributor" content="A. van der Lugt" />
<meta name="article:published_time" content="2021-01-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Plaque ulceration is a marker of previous plaque rupture. We studied the association between atherosclerotic plaque composition at baseline and plaque ulceration at baseline and follow-up.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We included symptomatic patients with a carotid stenosis of &amp;lt;70% who underwent MDCTA and MR imaging at baseline (&lt;i&gt;n&lt;/i&gt; = 180). MDCTA was repeated at 2 years (&lt;i&gt;n&lt;/i&gt; = 73). We assessed the presence of ulceration using MDCTA. Baseline MR imaging was used to assess the vessel wall volume and the presence and volume of plaque components (intraplaque hemorrhage, lipid-rich necrotic core, and calcifications) and the fibrous cap status. Associations at baseline were evaluated with binary logistic regression and reported with an OR and its 95% CI. Simple statistical testing was performed in the follow-up analysis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;At baseline, the prevalence of plaque ulceration was 27% (49/180). Increased wall volume (OR  = 12.1; 95% CI, 3.5–42.0), higher relative lipid-rich necrotic core (OR = 1.7; 95% CI, 1.3–2.2), higher relative intraplaque hemorrhage volume (OR = 1.7; 95% CI, 1.3–2.2), and a thin-or-ruptured fibrous cap (OR = 3.4; 95% CI, 1.7–6.7) were associated with the presence of ulcerations at baseline. In 8% (6/73) of the patients, a new ulcer developed. Plaques with a new ulceration at follow-up had at baseline a larger wall volume (1.04 cm&lt;sup&gt;3&lt;/sup&gt; [IQR, 0.97–1.16 cm&lt;sup&gt;3&lt;/sup&gt;] versus 0.86 cm&lt;sup&gt;3&lt;/sup&gt; [IQR, 0.73–1.00 cm&lt;sup&gt;3&lt;/sup&gt;]; &lt;i&gt;P &lt;/i&gt;= .029), a larger relative lipid-rich necrotic core volume (23% [IQR, 13–31%] versus 2% [IQR, 0–14%]; &lt;i&gt;P &lt;/i&gt;= .002), and a larger relative intraplaque hemorrhage volume (14% [IQR, 8–24%] versus 0% [IQR, 0–5%]; &lt;i&gt;P &lt;/i&gt;&amp;lt; .001).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Large atherosclerotic plaques and plaques with intraplaque hemorrhage and lipid-rich necrotic cores were associated with plaque ulcerations at baseline and follow-up.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="K. Dilba" />
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<meta name="citation_author" content="D.H.K. van Dam-Nolen" />
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<meta name="twitter:title" content="Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Plaque ulceration is a marker of previous plaque rupture. We studied the association between atherosclerotic plaque composition at baseline and plaque ulceration at baseline and follow-up.

MATERIALS AND METHODS: We included symptomatic patients with a carotid stenosis of &lt;70% who underwent MDCTA and MR imaging at baseline ( n  = 180). MDCTA was repeated at 2 years ( n  = 73). We assessed the presence of ulceration using MDCTA. Baseline MR imaging was used to assess the vessel wall volume and the presence and volume of plaque components (intraplaque hemorrhage, lipid-rich necrotic core, and calcifications) and the fibrous cap status. Associations at baseline were evaluated with binary logistic regression and reported with an OR and its 95% CI. Simple statistical testing was performed in the follow-up analysis.

RESULTS: At baseline, the prevalence of plaque ulceration was 27% (49/180). Increased wall volume (OR  = 12.1; 95% CI, 3.5–42.0), higher relative lipid-rich necrotic core (OR = 1.7; 95% CI, 1.3–2.2), higher relative intraplaque hemorrhage volume (OR = 1.7; 95% CI, 1.3–2.2), and a thin-or-ruptured fibrous cap (OR = 3.4; 95% CI, 1.7–6.7) were associated with the presence of ulcerations at baseline. In 8% (6/73) of the patients, a new ulcer developed. Plaques with a new ulceration at follow-up had at baseline a larger wall volume (1.04 cm3 [IQR, 0.97–1.16 cm3] versus 0.86 cm3 [IQR, 0.73–1.00 cm3]; P  = .029), a larger relative lipid-rich necrotic core volume (23% [IQR, 13–31%] versus 2% [IQR, 0–14%]; P  = .002), and a larger relative intraplaque hemorrhage volume (14% [IQR, 8–24%] versus 0% [IQR, 0–5%]; P  &lt; .001).

CONCLUSIONS: Large atherosclerotic plaques and plaques with intraplaque hemorrhage and lipid-rich necrotic cores were associated with plaque ulcerations at baseline and follow-up.

AUC
:   area under the curve
IPH
:   intraplaque hemorrhage
IQR
:   interquartile range
LRNC
:   lipid-rich necrotic core
TRFC
:   thick versus thin-or-ruptured fibrous cap" />
<meta name="og-title" property="og:title" content="Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/42/1/144" />
<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: Plaque ulceration is a marker of previous plaque rupture. We studied the association between atherosclerotic plaque composition at baseline and plaque ulceration at baseline and follow-up.

MATERIALS AND METHODS: We included symptomatic patients with a carotid stenosis of &lt;70% who underwent MDCTA and MR imaging at baseline ( n  = 180). MDCTA was repeated at 2 years ( n  = 73). We assessed the presence of ulceration using MDCTA. Baseline MR imaging was used to assess the vessel wall volume and the presence and volume of plaque components (intraplaque hemorrhage, lipid-rich necrotic core, and calcifications) and the fibrous cap status. Associations at baseline were evaluated with binary logistic regression and reported with an OR and its 95% CI. Simple statistical testing was performed in the follow-up analysis.

RESULTS: At baseline, the prevalence of plaque ulceration was 27% (49/180). Increased wall volume (OR  = 12.1; 95% CI, 3.5–42.0), higher relative lipid-rich necrotic core (OR = 1.7; 95% CI, 1.3–2.2), higher relative intraplaque hemorrhage volume (OR = 1.7; 95% CI, 1.3–2.2), and a thin-or-ruptured fibrous cap (OR = 3.4; 95% CI, 1.7–6.7) were associated with the presence of ulcerations at baseline. In 8% (6/73) of the patients, a new ulcer developed. Plaques with a new ulceration at follow-up had at baseline a larger wall volume (1.04 cm3 [IQR, 0.97–1.16 cm3] versus 0.86 cm3 [IQR, 0.73–1.00 cm3]; P  = .029), a larger relative lipid-rich necrotic core volume (23% [IQR, 13–31%] versus 2% [IQR, 0–14%]; P  = .002), and a larger relative intraplaque hemorrhage volume (14% [IQR, 8–24%] versus 0% [IQR, 0–5%]; P  &lt; .001).

CONCLUSIONS: Large atherosclerotic plaques and plaques with intraplaque hemorrhage and lipid-rich necrotic cores were associated with plaque ulcerations at baseline and follow-up.

AUC
:   area under the curve
IPH
:   intraplaque hemorrhage
IQR
:   interquartile range
LRNC
:   lipid-rich necrotic core
TRFC
:   thick versus thin-or-ruptured fibrous cap" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node88221--5" data-node-nid="88221" id="top-node-88221--61387929581" data-pisa="ajnr;42/1/144" data-pisa-master="ajnr;ajnr.A6868" data-apath="/ajnr/42/1/144.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>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K. Dilba</span>, <span class="highwire-citation-author" data-delta="1">D.H.K. van Dam-Nolen</span>, <span class="highwire-citation-author" data-delta="2">A.C. van Dijk</span>, <span class="highwire-citation-author" data-delta="3">M. Kassem</span>, <span class="highwire-citation-author" data-delta="4">A.F.W. van der Steen</span>, <span class="highwire-citation-author" data-delta="5">P.J. Koudstaal</span>, <span class="highwire-citation-author" data-delta="6">P.J. Nederkoorn</span>, <span class="highwire-citation-author" data-delta="7">J. Hendrikse</span>, <span class="highwire-citation-author" data-delta="8">M.E. Kooi</span>, <span class="highwire-citation-author" data-delta="9">J.J. Wentzel</span> and <span class="highwire-citation-author" data-delta="10">A. van der Lugt</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">January 2021,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">144-151; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6868 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-88221--61387929581" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">K. Dilba </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 Radiology and Nuclear Medicine (K.D., D.H.K.v.D.-N., A.C.v.D., A.v.d.L.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Cardiology (K.D., A.F.W.v.d.S., J.J.W.)</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=K.%2BDilba%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=Dilba%20K&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%3AK.%2BDilba%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/0000-0002-7349-0894" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. Dilba</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D.H.K. van Dam-Nolen </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 Radiology and Nuclear Medicine (K.D., D.H.K.v.D.-N., A.C.v.D., A.v.d.L.)</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.H.K.%2Bvan%2BDam-Nolen%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%20Dam-Nolen%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.H.K.%2Bvan%2BDam-Nolen%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/0000-0002-4527-3876" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.H.K. van Dam-Nolen</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.C. van Dijk </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 Radiology and Nuclear Medicine (K.D., D.H.K.v.D.-N., A.C.v.D., A.v.d.L.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (A.C.v.D., P.J.K.), Erasmus University Medical Center Rotterdam, Rotterdam, 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=A.C.%2Bvan%2BDijk%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%20Dijk%20A&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%3AA.C.%2Bvan%2BDijk%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/0000-0002-1301-9793" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.C. van Dijk</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M. Kassem </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology and Nuclear Medicine (M.K., M.E.K.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Center+, Maastricht, 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.%2BKassem%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=Kassem%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.%2BKassem%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/0000-0001-8392-2323" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Kassem</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A.F.W. van der Steen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Cardiology (K.D., A.F.W.v.d.S., J.J.W.)</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=A.F.W.%2Bvan%2Bder%2BSteen%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%20der%20Steen%20A&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%3AA.F.W.%2Bvan%2Bder%2BSteen%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/0000-0002-8045-7363" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.F.W. van der Steen</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">P.J. Koudstaal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology (A.C.v.D., P.J.K.), Erasmus University Medical Center Rotterdam, Rotterdam, 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=P.J.%2BKoudstaal%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=Koudstaal%20P&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%3AP.J.%2BKoudstaal%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/0000-0003-4998-9609" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.J. Koudstaal</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">P.J. Nederkoorn </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurology (P.J.N.), University Medical Center Amsterdam, Amsterdam, 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=P.J.%2BNederkoorn%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=Nederkoorn%20P&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%3AP.J.%2BNederkoorn%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/0000-0001-7386-4545" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.J. Nederkoorn</a></li></ul></div><div class="author-tooltip-7"><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'>f</span>Department of Radiology (J.H.), University Medical Center Utrecht, 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=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-8"><div class="author-tooltip-name">M.E. Kooi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology and Nuclear Medicine (M.K., M.E.K.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Center+, Maastricht, 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.E.%2BKooi%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=Kooi%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.E.%2BKooi%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/0000-0001-7562-5724" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.E. Kooi</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">J.J. Wentzel </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Cardiology (K.D., A.F.W.v.d.S., J.J.W.)</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.J.%2BWentzel%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=Wentzel%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.J.%2BWentzel%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/0000-0001-9893-3404" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.J. Wentzel</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">A. van der Lugt </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 Radiology and Nuclear Medicine (K.D., D.H.K.v.D.-N., A.C.v.D., A.v.d.L.)</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=A.%2Bvan%2Bder%2BLugt%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%20der%20Lugt%20A&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%3AA.%2Bvan%2Bder%2BLugt%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/0000-0002-6159-2228" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. van der Lugt</a></li></ul></div></div></div>  </div>

  
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    	<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">Jan 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">144-151; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6868 </span></div>
  
  
  
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      <div class="highwire-cite-title">Plaque Composition as a Predictor of Plaque Ulceration in Carotid Artery Atherosclerosis: The Plaque At RISK Study</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">K.</span> <span class="nlm-surname">Dilba</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">D.H.K.</span> <span class="nlm-surname">van Dam-Nolen</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.C.</span> <span class="nlm-surname">van Dijk</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Kassem</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.F.W.</span> <span class="nlm-surname">van der Steen</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.J.</span> <span class="nlm-surname">Koudstaal</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">P.J.</span> <span class="nlm-surname">Nederkoorn</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Hendrikse</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.E.</span> <span class="nlm-surname">Kooi</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.J.</span> <span class="nlm-surname">Wentzel</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">A.</span> <span class="nlm-surname">van der Lugt</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">Jan 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">144-151; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6868 </span></div>
  
  
  
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