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Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging

  • Diagnostic Neuroradiology
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Abstract

Introduction

Cilostazol, an antiplatelet agent, is reported to induce the regression of atherosclerotic changes. However, its effects on carotid plaques are unknown. Hence, we quantitatively investigated the changes that occur within carotid plaques during cilostazol administration using three-dimensional (3D) ultrasonography (US) and non-gated magnetic resonance (MR) plaque imaging.

Methods

We prospectively examined 16 consecutive patients with carotid stenosis. 3D-US and T1-weighted MR plaque imaging were performed at baseline and 6 months after initiating cilostazol therapy (200 mg/day). We measured the volume and grayscale median (GSM) of the plaques from 3D-US data. We also calculated the contrast ratio (CR) of the carotid plaque against the adjacent muscle and areas of the intraplaque components: fibrous tissue, lipid, and hemorrhage components.

Results

The plaque volume on US decreased significantly (median at baseline and 6 months, 0.23 and 0.21 cm3, respectively; p = 0.03). In the group exhibiting a plaque volume reduction of more than 10%, GSM on US increased significantly (24.8 and 71.5, respectively; p = 0.04) and CR on MRI decreased significantly (1.13 and 1.04, respectively; p = 0.02). In this group, in addition, the percent area of the fibrous component on MRI increased significantly (68.6% and 79.4%, respectively; p = 0.02), while those of the lipid and hemorrhagic components decreased (24.9% and 20.5%, respectively; p = 0.12) (1.0% and 0.0%, respectively; p = 0.04). There were no substantial changes in intraplaque characteristics in either US or MRI in the other group.

Conclusions

3D-US and MR plaque imaging can quantitatively detect changes in the size and composition of carotid plaques during cilostazol therapy.

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Acknowledgements

This work was partly supported by a Grant-in-Aid for Strategic Medical Science Research and Grants-in-Aid for Science Research (22890169, 22590963) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and by a Research Grant for Cardiovascular Diseases (20C-1) from the Ministry of Heath, Labor and Welfare of Japan.

Conflict of interest

MS has served as a consultant for Hitachi Medical Corporation and has received honoraria for lectures from Hitachi Medical Corporation, GE Healthcare, and Otsuka Pharmaceutical Corporation.

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Authors and Affiliations

  1. Department of Neurology and Gerontology, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Mao Yamaguchi, Hideki Ohba, Kiyofumi Mori, Shinsuke Narumi, Noriyuki Katsura, Kazumasa Ohura & Yasuo Terayama

  2. Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Makoto Sasaki & Kohsuke Kudo

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  1. Mao Yamaguchi
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  2. Makoto Sasaki
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  9. Yasuo Terayama
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Correspondence to Makoto Sasaki.

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Yamaguchi, M., Sasaki, M., Ohba, H. et al. Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging. Neuroradiology 54, 939–945 (2012). https://doi.org/10.1007/s00234-012-1011-2

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