March 04, 2014
MRI could be a useful tool to determine stroke and heart attack in people who do not have a history of cardiovascular disease.According to a new study in the journal Radiology, MRI plaque imaging in combination with carotid artery ultrasound was able to assess carotid plaque composition and predict the risk of a future cardiovascular event in study subjects. MRI was able to discern features of plaque, which is dangerous because of its vulnerability to rupture.

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“The results bolster the use of MRI as a surrogate marker of efficacy in therapeutic studies and point to a role in determining which patients might need more aggressive treatments,” said Dr. David A. Bluemke from the National Institutes of Health Clinical Center in Bethesda in a press release. “As risk factor prediction gets better, we’ll be able to screen more intelligently and use more intensive treatments in those individuals who face a higher risk of cardiovascular events.”

Researchers examined 946 asymptomatic patients for the study. Imaging results were compared with cardiovascular events, including heart attacks, stroke and death, for an average of 5.5 years after examination.

Cardiovascular events occurred in 59 of the patients. Abnormal thickening of the carotid artery wall and the presence of lipid core and calcium in the internal carotid artery on MRI were significant predictors of subsequent events, according to written material from RSNA. Almost half of the patients who had a cardiovascular event had lipid core present.

“The primary factors that predicted future risk were measures of vessel wall thickness in combination with the presence or absence of a lipid core,” Bluemke said.

According to the study, MRI did a better job identifying the risk in patients: approximately 16 percent more patients with events and 7 percent without events were correctly reclassified with MRI compared with the use of traditional risk factors.

CT has also been proven effective in evaluating the risk of heart attacks and other adverse cardiac events. But if given the option, many might chose MRI over CT to avoid being exposed to radiation from CT scans. Still, costs could be a barrier for screening with both these technologies.


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