MRI-based carotid artery measurements improve CVD risk assessment

MRI wall thickness measurements of a patient’s carotid arteries improves the quality of cardiovascular disease risk assessment, according to a new study published in Radiology.

“The carotid artery serves as [a] window into the cardiovascular system,” lead author Bruce A. Wasserman, MD, of Johns Hopkins University School of Medicine in Baltimore, said in a prepared statement. “Plaque developing in the carotid artery can contribute directly to a stroke, and its features—which determine its vulnerability to rupture—are closely related to those found in coronary artery plaque in the same patients.”

The authors enrolled 698 patients from the Multi-Ethnic Study of Atherosclerosis (MESA) from July 2000 to December 2013. Patients had a mean age of 63 years old at their first visit and no known history of cardiovascular disease. Patients underwent ultrasound and MRI between 2000 and 2004 to compare carotid artery wall thickness. Then, during follow-up, the team looked for relationships between those carotid artery wall thickness measurements and if the patient had coronary heart disease or stroke.

According to Wasserman, the team’s findings surprised them. The association between wall thickness and cardiovascular events was stronger with contrast-enhanced MRI and non-contrast-enhanced MRI than it was for the ultrasound-based carotid intima-media thickness (IMT) test, which is commonly used to assess early-stage carotid atherosclerosis.

“MRI measures of carotid artery wall thickness were more consistently associated with cardiovascular events than was intima-media thickness using ultrasound,” Wasserman said. “This tells us that perhaps MRI could be a better predictor of cardiovascular events, especially stroke.”

More research is still needed, the authors noted, and the costs associated with MRI must be considered before any decisions are made about using such measurements to investigate the possibility of future adverse cardiovascular events.