Abstract:
INTRODUCTION:To determine the association between magnetic resonance imaging (MRI)-detected vulnerable Carotid Plaques and clinical presentation related to ipsilateral carotid artery territory. EVIDENCE ACQUISITION:We searched three databases including Ovid MEDLINE, Ovid EMBASE, and Scopus from 2000 to 2018 for studies that evaluated vulnerable carotid plaques by MRI defined as intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), or thinning/rupture of the fibrous cap (TRFC). Data on study characteristics, clinical presentation, and MRI findings were extracted. Publication bias, methodologic quality, and study heterogeneity were assessed. Random-effects meta-analysis model was used to estimate incidence rate ratio (IRR) and 95% confidence intervals (CI) of MRI-detected vulnerable carotid plaque between symptomatic and asymptomatic arteries. EVIDENCE SYNTHESIS:Of 2855 studies, 33 studies containing 6210 participants with 8401 assessed arteries were included. Overall, the risk of bias was moderate in 13, and low in 20 studies. The prevalence of MRI-positive IPH, TRFC, and LRNC were higher in symptomatic groups compared with the asymptomatic groups. In 11 studies that compared vulnerable carotid plaques between symptomatic and asymptomatic groups, symptomatic presentation was correlated with increased risk of IPH (IRR=1.57; 95% CI: 1.24-1.99), TRFC (IRR=2.26; 95% CI: 1.83 to 3.76), and LRNC (IRR=1.95; 95% CI: 1.28 to 2.97), respectively. CONCLUSIONS:The presence of MRI-positive vulnerable carotid plaques including IPH, LRNC, and TRFC is positively associated with symptomatic clinical presentation. Therefore, carotid plaque MRI might be a useful risk stratification tool in determining the risk of ischemic stroke.
journal_name
J Neurosurg Scijournal_title
Journal of neurosurgical sciencesauthors
Seyedsaadat SM,Rizvi A,Alzuabi M,Dugani SB,Murad MH,Huston J 3rd,Saba L,Brinjikji Wdoi
10.23736/S0390-5616.19.04820-3subject
Has Abstractpub_date
2020-06-01 00:00:00pages
263-271issue
3eissn
0390-5616issn
1827-1855pii
S0390-5616.19.04820-3journal_volume
64pub_type
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journal_title:Journal of neurosurgical sciences
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abstract:AIM:The challenge in large cranial base meningiomas is total resection of the tumor with the least possible mortality and morbidity. During the last two decades the technical approaches for anterior skull base tumors have shown a considerable progress, providing a wide exposure with minimal brain retraction. The purpos...
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journal_title:Journal of neurosurgical sciences
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journal_title:Journal of neurosurgical sciences
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journal_title:Journal of neurosurgical sciences
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journal_title:Journal of neurosurgical sciences
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
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journal_title:Journal of neurosurgical sciences
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-01-01 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
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journal_title:Journal of neurosurgical sciences
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doi:
更新日期:1979-04-01 00:00:00
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
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doi:
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章,评审
doi:
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journal_title:Journal of neurosurgical sciences
pub_type: 杂志文章
doi:
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journal_title:Journal of neurosurgical sciences
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