News | Magnetic Resonance Imaging (MRI) | November 24, 2015

3-D MRI Shows Early Signs of Stroke Risk in Diabetic Patients

Researchers used 3-D MRI to study the carotid arteries in diabetic patients for evidence of intraplaque hemorrhage (IPH), an indicator of advanced atherosclerotic disease

IPH, intraplaque hemorrhage, diabetic patients, stroke risk, 3-D MRI

Image A shows the 3-D MRI intraplaque hemorrhage (IPH) sequence as acquired in the coronal plane. The red dotted line indicates the level at which the reformatted axial plane, B, was obtained. C shows the section of the right carotid artery with a region of high signal consistent with IPH. Contours are drawn for the outer wall (green) and lumen (red) with the area of IPH in this segment shaded blue in D.

November 24, 2015 — People with diabetes may be harboring advanced vascular disease that could increase their risk of stroke, according to new research being presented next week at the annual meeting of the Radiological Society of North America (RSNA). The findings suggest that arterial imaging with 3-D magnetic resonance imaging (MRI) could be useful in helping to determine stroke risk among diabetics.

The carotid arteries are vessels on each side of the neck that supply oxygenated blood to the head. Narrowing of the carotid arteries is associated with risk of stroke, but less is known about stroke risk in people with little or no narrowing of these arteries.

For the new study, researchers used 3-D MRI to study the carotid arteries for evidence of intraplaque hemorrhage (IPH), an indicator of advanced atherosclerotic disease.

"A recent analysis of multiple studies has shown that people with carotid artery narrowing and IPH have a five- to six-times higher risk of stroke in the near future compared to people without," said study author Tishan Maraj, M.B.B.S., imaging analyst at Sunnybrook Research Institute and M.Sc. candidate at the University of Toronto in Toronto, Canada.

Maraj and colleagues focused their study on people with diabetes, a group already facing a significantly increased risk of strokes with worse outcomes than the non-diabetic population. They used 3-D MRI to investigate the prevalence of carotid IPH in 159 asymptomatic type 2 diabetic patients, average age 63, recruited from a dietary trial between 2010 and 2013.

Of the 159 patients imaged, 37, or 23.3 percent, had IPH in at least one carotid artery. Five of the 37 patients had IPH in both carotid arteries. IPH was found in the absence of carotid artery stenosis, or narrowing, and was associated with an increased carotid artery wall volume as measured by 3-D MRI.

"It was surprising that so many diabetic patients had this feature," Maraj said. "We already knew that people with diabetes face three to five times the risk of stroke, so perhaps IPH is an early indicator of stroke risk that should be followed up."

While 2-D MRI has been used for more than a decade to identify and characterize carotid artery plaques, the 3-D method brings an extra level of imaging power, Maraj noted.

"The advantage of 3-D MRI is you can image the entire carotid artery and pinpoint the area of interest over a shorter period of time compared with multiple 2-D sequences," he said.

Maraj emphasized that the study did not look at outcomes for the patients and did not draw any conclusions on whether people with IPH will develop carotid artery blockages more quickly than those with no IPH present. However, it is already known that blood is a destabilizing factor of plaque that promotes rupture, setting off a chain of events that can lead to a stroke.

Although there is no treatment for IPH at this time, Maraj said identification of it may help with risk stratification and could even have applications in the non-diabetic population.

"Even though you can't treat IPH, you can monitor patients a lot more closely," he said.

Co-authors on the study are Alan R. Moody, M.D., FRCP, FRCR; Navneet Singh, M.D.; Tina Binesh Marvasti, M.Sc.; Mariam Afshin, Ph.D., M. Eng.; Pascal N. Tyrrell, Ph.D.; and David Jenkins, M.D., Ph.D., D.Sc.

For more information: www.radiologyinfo.org

Related Content

Breast Cancer Screening Performance Impacted by Mean Mammographic Compression Pressure
News | Mammography | December 08, 2017
Dutch researchers demonstrated a strong relationship between compression pressure in mammography and breast cancer...
Sponsored Content | Videos | Magnetic Resonance Imaging (MRI) | December 07, 2017
Max Wintermark, M.D., professor of radiology and chief of neuroradiology, Stanford Hospital and Clinics, discussed MR
Technology | Neuro Imaging | December 07, 2017
Deep learning artificial intelligence (AI) medical company DeepRadiology  announced the world's first computed...
Sponsored Content | Videos | Advanced Visualization | December 07, 2017
Dianna Bardo M.D., director of body MR and co-director of the 3-D Innovation Lab at Phoenix Children's Hospital.
Sponsored Content | Videos | Artificial Intelligence | December 07, 2017
Adam Flanders, M.D., co-director, neuroradiology and vice-chair of informatics at Jefferson University Hospitals, Phi
Sponsored Content | Videos | Mammography | December 06, 2017
Martin Yaffe, Ph.D., FAAPM, senior scientist, physical sciences/imaging research, Sunnybrook Health Sciences Centre,
Brain's Appetite Regulator Disrupted in Obese Teens
News | Neuro Imaging | December 05, 2017
December 5, 2017 — Advanced...
Sponsored Content | Videos | Breast Imaging | December 05, 2017
Stamatia Destounis, M.D., FACR, associate professor, University of Rochester School of Medicine, attending radiologis
Toshiba Launches Vantage Elan Zen Edition MR for Enhanced Patient Comfort
Technology | Magnetic Resonance Imaging (MRI) | December 05, 2017
Toshiba Medical, a Canon Group company, introduced its newest magnetic resonance (MR) system, the Vantage Elan/Zen...
Philips Azurion Platform Improves Clinical Workflow and Staff Experience Benefits
News | Angiography | December 04, 2017
Philips recently announced the results of a comprehensive, independent, two-year study demonstrating the clinical...
Overlay Init