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Research ArticleAdult Brain
Open Access

Intracranial Atherosclerotic Burden on 7T MRI Is Associated with Markers of Extracranial Atherosclerosis: The SMART-MR Study

M.H.T. Zwartbol, M.I. Geerlings, R. Ghaznawi, J. Hendrikse, A.G. van der Kolk and on behalf of the UCC-SMART Study Group
American Journal of Neuroradiology December 2019, 40 (12) 2016-2022; DOI: https://doi.org/10.3174/ajnr.A6308
M.H.T. Zwartbol
aFrom the Department of Radiology (M.H.T.Z., R.G., J.H., A.G.v.d.K.)
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  • ORCID record for M.H.T. Zwartbol
M.I. Geerlings
bJulius Center for Health Sciences and Primary Care (M.I.G., R.G.), University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
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  • ORCID record for M.I. Geerlings
R. Ghaznawi
aFrom the Department of Radiology (M.H.T.Z., R.G., J.H., A.G.v.d.K.)
bJulius Center for Health Sciences and Primary Care (M.I.G., R.G.), University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
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J. Hendrikse
aFrom the Department of Radiology (M.H.T.Z., R.G., J.H., A.G.v.d.K.)
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A.G. van der Kolk
aFrom the Department of Radiology (M.H.T.Z., R.G., J.H., A.G.v.d.K.)
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    FIGURE.

    Examples of intracranial vessel wall lesions on vessel wall MR imaging in a 76-year-old male patient with a history of coronary artery disease. A detailed description of the rating criteria can be found in the Materials and Methods section. A, Lesion in lateral wall of the right P2 segment (arrow) versus the nondiscernable normal neighboring medial wall (arrowhead). B, Lesion in the right vertebral (arrow) and left vertebral (arrowhead) arteries. C, Lesion in the proximal basilar artery (arrow), with coronal orientation shown in enclosed panel (arrowhead). D, Lesion in the C7 segment of the right ICA (arrow), compared with the normal-appearing contralateral C7 segment (arrowhead) and proximal right M1 segment. Furthermore, note the long lesion in the distal half of the right P2 segment (gray arrow) and focal lesion in the left P2 segment (dual arrow).

Tables

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    Table 1:

    Markers of extracranial atherosclerosis (N = 130)a

    Markers
    Age (yr)68 ± 9
    Male88%
    Carotid IMT (mm)0.84 ± 0.22
    Carotid stenosisb
     No stenosis23%
     1%–49% stenosis70%
     50%–100% stenosisc7%
    Ankle-brachial index
     ABI1.09 ± 0.18
     ABI ≤ 0.911%
    Renal function
     eGFR (mL/min)72.8 ± 17.3
     eGFR <60 mL/min21%
    History of vascular diseased
     Cerebrovascular disease9%
     Coronary artery disease65%
     Peripheral artery disease9%
     Multivascular disease17%
    • Note:—IMT indicates intima-media thickness.

    • ↵a Values are presented as mean ± SD for continuous variables and percentages for categorical variables.

    • ↵b Categories are mutually exclusive. Patients were categorized according to most severe stenosis grade.

    • ↵c Includes 4 patients with ≥1 carotid artery occlusion.

    • ↵d Categories are mutually exclusive. The multivascular category consisted of 22 patients with a history of ≥2 vascular diseases: Ninety-five percent had coronary artery disease; 60%, cerebrovascular disease; 60%, peripheral artery disease; and 14%, abdominal aortic aneurysm.

    • View popup
    Table 2:

    Association between carotid atherosclerosis and ICAS burden

    ICAS Burden (b-value)a (95% CI)
    cIMT, per +0.1  mm0.53 (0.06–0.98)
    cIMT quartiles
     Quartile 10 (Reference)
     Quartile 20.62 (−2.31–3.55)
     Quartile 30.40 (−2.61–3.41)
     Quartile 42.89 (−0.01–5.80)
    Carotid stenosis
     No stenosis0 (Reference)
     1%–49% stenosis2.48 (0.08–4.89)
     50%–100% stenosis6.62 (2.34–10.93)
    • ↵a B-values are unstandardized linear regression coefficients adjusted for age and sex.

    • View popup
    Table 3:

    Association between ABI and ICAS burden

    ICAS Burden (b-value)a (95% CI)
    ABI, per +0.1 in ratio−0.36 (−0.91–0.19)
    ABI > 0.90 (Reference)
    ABI ≤ 0.94.86 (1.74–7.99)
    • ↵a B-values are unstandardized linear regression coefficients adjusted for age and sex.

    • View popup
    Table 4:

    Association between renal function and ICAS burden

    ICAS Burden (b-value)a (95% CI)
    eGFR, per +10 mL/min−0.77 (−1.50 to −0.03)
    eGFR ≥60 mL/min0 (Reference)
    eGFR <60 mL/min3.18 (0.45–5.91)
    • ↵a B-values are unstandardized linear regression coefficients adjusted for age and sex.

    • View popup
    Table 5:

    Association between history of vascular disease and ICAS burden

    ICAS Burden (b-value)a (95% CI)
    Coronary artery disease0 (Reference)
    Peripheral artery disease−0.22 (−3.99–3.55)
    Cerebrovascular disease0.01 (−3.46–3.48)
    Multivascular disease2.08 (−0.60–4.76)
    • ↵a B-values are unstandardized linear regression coefficients adjusted for age and sex. Categories are mutually exclusive.

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American Journal of Neuroradiology: 40 (12)
American Journal of Neuroradiology
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M.H.T. Zwartbol, M.I. Geerlings, R. Ghaznawi, J. Hendrikse, A.G. van der Kolk, on behalf of the UCC-SMART Study Group
Intracranial Atherosclerotic Burden on 7T MRI Is Associated with Markers of Extracranial Atherosclerosis: The SMART-MR Study
American Journal of Neuroradiology Dec 2019, 40 (12) 2016-2022; DOI: 10.3174/ajnr.A6308

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Intracranial Atherosclerotic Burden on 7T MRI Is Associated with Markers of Extracranial Atherosclerosis: The SMART-MR Study
M.H.T. Zwartbol, M.I. Geerlings, R. Ghaznawi, J. Hendrikse, A.G. van der Kolk, on behalf of the UCC-SMART Study Group
American Journal of Neuroradiology Dec 2019, 40 (12) 2016-2022; DOI: 10.3174/ajnr.A6308
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