22. European Stroke Conference 7 Vascular imaging 9:30 - 9:40 Carotid Intima-Media Thickness and Carotid Plaque are Distinct Atherosclerotic Pheno-types D. Della-Morte1, H. Gardener2, E.A. Hale3, C. Dong4, E. Tiozzo5, K. Cheung6, C. Mora-Mc- Laughlin7, M.S. Elkind8, R.L. Sacco9, T. Rundek10 Department of Neurology, University of Miami, Miller School of Medicine and Depart-ment of Advanced Biotechnologies and Bioimaging, San Raffaele, Rome, Miami, US-A1, Department of Neurology, University of Miami, Miller School of Medicine, Miami, USA2, Department of Neurology, University of Miami, Miller School of Medicine, Miami, USA3, Department of Neurology, University of Miami, Miller School of Medicine, Miami, USA4, Department of Psychiatry, University of Miami, Miller School of Medicine, Miami, USA5, De-partment of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA6, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA7, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, USA8, Department of Neurology, University of Miami, Miller School of Medicine, Miami, USA9, Department of Neurology, University of Miami, Miller School of Medicine, Miami, USA10 Background: Carotid intima–media thickness (cIMT) and carotid plaque (CP) are biomarkers of subclinical atherosclerosis associated with increased stroke risk. However, whether cIMT and CP are distinct phenotypes or single traits at a different stage of atherosclerosis is not clear. This study aimed to explore the relationship between these markers in the multiethnic popula-tion- based Northern Manhattan Study (NOMAS). Methods: We studied the cross-sectional and prospective relationship between cIMT and CP among 1788 NOMAS participants. Different carotid segments were assessed by high-resolution ultrasound using validated imaging protocols at 2 time-points (mean time between 2 examina-tions= 3.5 years; range: 1.9-7.3; n=768). Results: The mean age was 65.5±8.9 years (40% male, 19% black, 17% white and 61% His-panic). Prevalence of CP was 58%, 37% had thick plaque (>1.9mm, the top quartile). The mean cIMT at baseline was 0.92±0.09mm, range=0.62-1.41mm (among those with plaque 0.94±0.09mm and 0.90±0.08mm among those without plaque; p<0.01). After adjusting for demographics and traditional vascular risk factors, each 0.1 mm increase in cIMT was asso-ciated with an increased odds of plaque presence (OR=1.72, 95%CI=1.51-1.97), thick plaque (OR=1.87, 95%CI 1.64-2.15), and top tertile of plaque area (OR=2.67, 95%CI 2.22-3.21). Elevated cIMT at baseline was associated with an increased risk of incident plaque during fol-low- up (per 0.1mm increase, OR=1.13, 95% CI 1.02-1.27) as well as with incident plaque in the subgroup without plaque at baseline (OR=1.24, 95% CI 1.03-1.50). After adjusting for de-mographics and vascular risk factors these associations were no longer present. Conclusion: Increased cIMT was associated with plaque prevalence at baseline but did not pre-dict CP incidence independent of other vascular risk factors after 3.5 years of follow-up. This finding suggests that cIMT may not be a predictor of CP although that these two atherosclerotic phenotypes often coexist. 6 Vascular imaging 9:20 - 9:30 Superiority of proton-density weighted MRI compared to standard MRI and color-coded duplex sonography detecting spontaneous dissection of extracranial and intracranial ar-teries M. Glaser1, M. Kanowski2, E. Elolf3, A. Gazis4, C. Scherlach5, M. Skalej6, H.-J. Heinze7, M. Goertler8 Department of Neurology, University of Magdeburg, Magdeburg, GERMANY1,Depart-ment of Neurology, University of Magdeburg, Magdeburg, GERMANY2, International Neu-roscience Institute, Hannover, GERMANY3, Institute of Neuroradiology, University of Mag-deburg, Magdeburg, GERMANY4, Institute of Neuroradiology, University of Magdeburg, Magdeburg, GERMANY5, Institute of Neuroradiology, University of Magdeburg, Magdeburg, GERMANY6, Department of Neurology, University of Magdeburg & Leibniz Institute for Neu-robiology, Magdeburg, GERMANY7, Department of Neurology, University of Magdeburg & Leibniz Institute for Neurobiology, Magdeburg, GERMANY8 Background: Intramural hematoma detected by fat-saturated T1-weighted MRI is the preferred diagnostic criterion and technique to detect spontaneous dissection of brain supplying arteries. High-resolution color-coded duplex sonography additionally enables visualization of helical mural hematoma in low diameter extracranial vertebral arteries. We aimed to evaluate pro-ton- density weighted MRI compared to standard MRI and color-coded duplex sonography to detect spontaneous dissection and to determine its longitudinal dimension. Methods: After informed consent, 12 (5 women, 7 men) asymptomatic or minor symptomatic patients (mean age 42 years) with vertebral artery dissection (VAD, 4) or carotid artery dissec-tion (CAD, 8) underwent additional proton-density MRI at 3 Tesla with 0.8 mm isometric voxel resolution. All patients had been investigated by standard MRI protocol (ToF-MRA, fat-saturat-ed T1 and T2 at 3 Tesla) and extracranial and intracranial color-coded duplex sonography. Ob-servers blinded for clinical symptoms and corresponding examinations independently assessed presence and dimension of CAD and VAD. Results: Helical intramural hematoma was visualized in all VAD and 2 (25%) CAD by duplex sonography by all observes. At standard MRI, 7 (88%) CAD and 2 (50%) VAD were detected by all observes, whereas distal (intracranial) extension was rated with only low agreement for both arteries. By proton-weighted MRI, helical intramural hematoma was detected in all CAD and VAD by all observers. Distal extension was rated superior to standard MRI mainly to high-er resolution and lower movement artifacts as a consequence of shorter examination time. Conclusion: Considering helical mural thickening as characteristic for spontaneous CAD and VAD, proton-density weighted high-resolution MRI at 3 Tesla may be superior to standard MRI technique and color-coded duplex sonography especially for the detection of VAD and the as-sessment of distal (intracranial) extension. 184 © 2013 S. Karger AG, Basel Scientific Programme
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