{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T23:07:44Z","timestamp":1768345664407,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T00:00:00Z","timestamp":1602288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The relationship between plaque characteristics and their predictive value for perioperative cerebral blood flow (CBF) are unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the relationship between carotid plaque characteristics and perioperative CBF utilizing MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>In all, 131 patients with carotid moderate\u2010to\u2010severe stenosis referred for carotid endarterectomy (CEA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3T, black\u2010blood T<jats:sub>1<\/jats:sub>\u2010 and T<jats:sub>2<\/jats:sub>\u2010weighted, 3D time\u2010of\u2010flight, and simultaneous noncontrast angiography intraplaque hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>The relative CBF (rCBF = CBF<jats:sub>index\u2010hemisphere<\/jats:sub>\/CBF<jats:sub>contralateral\u2010hemisphere<\/jats:sub>) and the CBF difference ratio (DR<jats:sub>CBF<\/jats:sub> =\u2009[CBF<jats:sub>post\u2010CEA<\/jats:sub> \u2013 CBF<jats:sub>pre\u2010CEA<\/jats:sub>]\/CBF<jats:sub>pre\u2010CEA<\/jats:sub>) in the middle cerebral artery territory were measured. The pre\u2010 and post\u2010CEA CTP data were used as the assessment standard for CBF change. Carotid lipid\u2010rich necrotic core (LRNC), intraplaque hemorrhage, calcification, fibrous cap rupture, maximum wall thickness, normalized wall index (NWI), and stenosis were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Pearson or Spearman correlation, Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test, and linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with LRNC had higher rCBF<jats:sub>pre\u2010CEA<\/jats:sub> than those without (1.0\u2009\u00b1\u20090.1 vs. 0.9\u2009\u00b1\u20090.1, <jats:italic>P<\/jats:italic> &lt;\u20090.05). NWI was weakly correlated with rCBF<jats:sub>pre\u2010CEA<\/jats:sub> (<jats:italic>r =<\/jats:italic> \u22120.213, <jats:italic>P<\/jats:italic> &lt;\u20090.05) and DR<jats:sub>CBF<\/jats:sub> (<jats:italic>r =<\/jats:italic> 0.185, <jats:italic>P<\/jats:italic> &lt;\u20090.05) and marginally correlated with rCBF<jats:sub>post\u2010CEA<\/jats:sub> (<jats:italic>r =<\/jats:italic> 0.166, <jats:italic>P<\/jats:italic> =\u20090.057). LRNC was weakly correlated with rCBF<jats:sub>pre\u2010CEA<\/jats:sub> (<jats:italic>r =<\/jats:italic> 0.179, <jats:italic>P<\/jats:italic> &lt;\u20090.05). NWI was associated with rCBF<jats:sub>pre\u2010CEA<\/jats:sub> (\u03b2 = \u22120.035; 95% confidence interval [CI] [\u22120.064, \u22120.006]; <jats:italic>P<\/jats:italic> &lt;\u20090.05), rCBF<jats:sub>post\u2010CEA<\/jats:sub> (\u03b2 = 0.042; 95% CI [0.002, 0.081]; <jats:italic>P<\/jats:italic> &lt;\u20090.05) and DR<jats:sub>CBF<\/jats:sub> (\u03b2 = 0.105; 95% CI [0.026, 0.185]; <jats:italic>P<\/jats:italic> &lt;\u20090.05). After adjusting for confounding factors, associations of NWI with rCBF<jats:sub>post\u2010CEA<\/jats:sub> (\u03b2 = 0.059; 95% CI [0.016, 0.103]; <jats:italic>P<\/jats:italic> &lt;\u20090.05) and DR<jats:sub>CBF<\/jats:sub> (\u03b2 = 0.110; 95% CI [0.021, 0.199]; <jats:italic>P<\/jats:italic> &lt;\u20090.05) remained statistically significant, while the association between NWI and rCBF<jats:sub>pre\u2010CEA<\/jats:sub> was no longer significant (\u03b2 = \u22120.026; 95% CI [\u22120.058, 0.006]; <jats:italic>P<\/jats:italic> =\u20090.112).The associations of LRNC with rCBF<jats:sub>pre\u2010CEA<\/jats:sub> (\u03b2 = 0.057; 95% CI [\u22120.0006, 0.114]; <jats:italic>P<\/jats:italic> =\u20090.052) and DR<jats:sub>CBF<\/jats:sub> (\u03b2 = \u22120.157; 95% CI [\u22120.314, 0.001]; <jats:italic>P<\/jats:italic> =\u20090.051) were close to statistical significance. After adjusting for confounding factors, these associations were statistically significant (of LRNC vs. rCBF<jats:sub>pre\u2010CEA<\/jats:sub>: \u03b2 = 0.060; 95% CI [0.003, 0.118]; <jats:italic>P<\/jats:italic> &lt;\u20090.05; LRNC vs. DR<jats:sub>CBF<\/jats:sub>: \u03b2 = \u22120.205; 95% CI [\u22120.375, \u22120.036]; <jats:italic>P<\/jats:italic> &lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Carotid plaque burden and components, particularly LRNC, might be effective indicators for CBF change following CEA.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold> 1<\/jats:p><jats:p><jats:bold>Technical Efficacy Stage<\/jats:bold> 5<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27365","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T10:20:36Z","timestamp":1602325236000},"page":"613-625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Associations Between Carotid Plaque Characteristics and Improvement of Cerebral Blood Perfusion in Patients With Moderate to Severe Carotid Stenosis Undergoing Carotid Endarterectomy"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3749-0253","authenticated-orcid":false,"given":"Ran","family":"Huo","sequence":"first","affiliation":[{"name":"Department of Radiology Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology Peking University Third Hospital  Beijing 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