Vulnerable lesion correlates to accelerated recurrence of cerebral infarction: Carotid MR imaging study

Objective: To test the hypothesis of a MRI-defined vulnerable plaque relating to quick reoccurrence of cerebrovascular events and evaluate potential usage of MRI in secondary prevention of ischemic stroke. Methods: Fifty symptomatic participants were recruited from patients who suffered from second time cerebral infarction. Patients were imaged within 7 days after reoccurrence of cerebral infarction. The type of carotid artery lesion was classified according to the signal in it. Then, we compared the interval of cerebral infarction between patients with and without vulnerable lesion and the prevalence of vulnerable lesion in patients with different intervals. A Cox proportional hazards model was constructed to calculate the influence of vulnerable lesion on the interval of cerebral infarction. Results: The mean recurrence interval of patients with vulnerable lesion was shorter than that of patients without vulnerable lesion (296.2 vs 1623.8, P<0.001). Vulnerable lesions were detected more frequent in patients with recurrent cerebral infarction within one year (80% vs 13.3%, P<0.001). The patients with vulnerable lesion had a 5.596-fold higher HR (HR=5.596, P<0.001, 95%CI 2.766-11.326) than those without it after adjustment of risk factors. Conclusion: MRI-defined vulnerable lesion in carotid artery related to accelerated recurrent cerebral infarction. MRI demonstrated its potential value in secondary prevention of cerebral infarction.