G12-1 Which modality is better to predict symptomatic recurrence in patients with carotid occlusive lesions, black-blood MRI (BB-MRI) vs carotid ultrasound?

BB-MRI has been recently reported to characterize carotid plaque morphology. The aim of this study was to assess carotid plaque findings by BB-MRI and carotid ultrasound in patient with carotid occlusive lesions and which modality is better to predict symptomatic recurrence within 30 days of hospitalization. We studied prospectively 37 consecutive stroke patients (37 carotid arteries) within 3 days of onset who presented with carotid artery stenosis (50% to 99%) or occlusion diagnosed by carotid ultrasound, between June 1, 2006 and May 31, 2007. We compared carotid plaque findings between BB-MRI T1WI high signal intensity and carotid ultrasound low echogenic signal to symptomatic recurrence. Three TIA and 34 cerebral infarction patients (18 atherothrombotic, 10 cardiogenic, two lacunar, and four other infarctions) were enrolled. Nine cases had symptomatic recurrence. Recurrence cases were found in 38% of BB-MRI T1WI high and 0% of non-high signal intensity. Also, they were found in 24% cases of carotid ultrasound low and 25% of non-low echogenic signal. Therefore, symptomatic recurrence was significantly higher in BB-MRI T1WI high signal intensity than carotid low echogenic signal. BB-MRI may be better than ultrasound to predict symptomatic recurrence following ischemic stroke in patients, with carotid occlusive lesions.