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BMC Medical Imaging

, 10:27

First Online: 30 November 2010Received: 28 January 2010Accepted: 30 November 2010


BackgroundPlaque imaging based on magnetic resonance imaging MRI represents a new modality for risk assessment in atherosclerosis. It allows classification of carotid plaques in high-risk and low-risk lesion types I-VIII. Type 2 diabetes mellitus DM 2 represents a known risk factor for atherosclerosis, but its specific influence on plaque vulnerability is not fully understood. This study investigates whether MRI-plaque imaging can reveal differences in carotid plaque features of diabetic patients compared to nondiabetics.

Methods191 patients with moderate to high-grade carotid artery stenosis were enrolled after written informed consent was obtained. Each patient underwent MRI-plaque imaging using a 1.5-T scanner with phased-array carotid coils. The carotid plaques were classified as lesion types I-VIII according to the MRI-modified AHA criteria. For 36 patients histology data was available.

ResultsEleven patients were excluded because of insufficient MR-image quality. DM 2 was diagnosed in 51 patients 28.3%. Concordance between histology and MRI-classification was 91.7% 33-36 and showed a Cohen-s kappa value of 0.81 with a 95% CI of 0.98-1.15. MRI-defined high-risk lesion types were overrepresented in diabetic patients n = 29; 56.8%. Multiple logistic regression analysis revealed association between DM 2 and MRI-defined high-risk lesion types OR 2.59; 95% CI 1.15-5.81, independent of the degree of stenosis.

ConclusionDM 2 seems to represent a predictor for the development of vulnerable carotid plaques irrespective of the degree of stenosis and other risk factors. MRI-plaque imaging represents a new tool for risk stratification of diabetic patients.

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Electronic supplementary materialThe online version of this article doi:10.1186-1471-2342-10-27 contains supplementary material, which is available to authorized users.

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Autor: L Esposito - T Saam - P Heider - Angelina Bockelbrink - Jaroslav Pelisek - D Sepp - R Feurer - C Winkler - T Liebig - K 


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