3D MRI could be used to determine hidden signs of stroke risk in people with diabetes, according to new research.
The study, conducted by researchers at Sunnybrook Research Institute, Canada, could detect advanced vascular disease, which increases the risk of stroke. Advanced vascular disease is a condition that affects many people with diabetes.
In most cases of stroke, the carotid arteries, which are vessels on the side of the neck that supply blood to the head, are significantly narrowed. However, narrowing of the carotid arteries does not occur in all cases of stroke. Little is known about stroke risk in people with no narrowing of the carotid arteries.
The researchers decided to use 3D MRI to look for intraplaque hemorrhage (IPH) in the carotid arteries.
“A recent analysis of multiple studies has shown that people with carotid artery narrowing and IPH have a five- to six-times higher risk of stroke in the near future compared to people without,” said Tishan Maraj, imaging analyst at Sunnybrook Research Institute and author of the study.
In this study, the researchers focused on people with diabetes, who already have a higher risk of stroke than people without diabetes. 3D MRI was used to look for carotid IPH in 159 participants, all of whom had type 2 diabetes and an average age of 63.
23.3 per cent of the participants had carotid IPH, despite many of them not having any narrowing in their carotid arteries.
“It was surprising that so many diabetic patients had this feature,” Dr. Maraj said. “We already knew that people with diabetes face three to five times the risk of stroke, so perhaps IPH is an early indicator of stroke risk that should be followed up.
“The advantage of 3D MRI is you can image the entire carotid artery and pinpoint the area of interest over a shorter period of time compared with multiple 2D sequences.”
There is currently no treatment for IPH, and this study does not suggest one. It does, however, suggest a new method of detecting stroke risk in people without the traditional symptoms – such as carotid artery narrowing.
“Even though you can’t treat IPH, you can monitor patients a lot more closely,” Maraj said.
The findings will be presented at the annual meeting of the Radiological Society of North America (RSNA).

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