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Imaging Iron and Atherosclerosis by Magnetic Resonance Imaging

出版	Ohio State University, 2015
URL	http://books.google.com.hk/books?id=GyfxjgEACAAJ&hl=&source=gbs_api

註釋Plaque buildup, or atherosclerosis, affects the carotid arteries that supply the brain, and is the underlying disease causing 87% of all strokes. Severe blockage (stenosis) alone can significantly reduce blood flow to the brain; just as often, plaques with moderate stenosis may unexpectedly rupture with obstruction ensuing from clot formation. Too often, carotid atherosclerosis goes undetected until after an event. Surgery can remove the plaque, but is currently reserved for patients with obvious symptoms and severe stenosis. In patients with severe stenosis who have already had a stroke, surgery can reduce the risk of another event. However, the 5-year risk of stroke is as high as 12.4% in patients who lack recognizable symptoms and do not have sufficient stenosis to meet current surgical guidelines. Strategies to characterize plaque beyond the current paradigm of solely measuring stenosis severity could help detect such at-risk patients and ideally prevent their atherosclerotic events. Our team has pioneered in vivo characterization of iron in carotid plaque using magnetic resonance imaging (MRI). Using an MRI parameter that varies with the local magnetic field in tissues called T2*, we have been able to distinguish symptom-producing from non-symptom producing plaques in patients with carotid atherosclerosis. However, self-reported symptoms are insensitive to the burden of cerebral infarction (e.g. subclinical strokes) by neuroimaging.