Project 22

Neurovascular imaging (MRI and CT)

Imaging
Ischemic cerebral infarcts are related to the presence of atherosclerotic disease in the carotid artery. Severity of the stenosis is a predictor of clinical symptoms and is used as parameter in the therapeutic decision as to which patients will benefit from carotid intervention. Next to stenosis, plaque morphology is thought to be a major determinant of cerebrovascular events.
Within this project, imaging of the atherosclerotic plaque in the carotid bifurcation with multidetector CT and MRI is evaluated. We focus on 1) the validation of imaging parameters by comparison of images with histology, 2) development of new structural and haemodynamic parameters of atherosclerotic disease, 3) development and validation of automated measurements, 4) prospective studies in patients and healthy volunteers to prove the additional value of plaque parameters in risk prediction, 5) Serial imaging studies to evaluate the natural course of the atherosclerotic disease, 6) Studies into the relationship between atherosclerotic plaque parameters and brain infarcts and white matter lesions on CT and MRI.

Treatment
Neurovascular diseases are increasingly treated with endovascular techniques (EVT). Ischemic stroke caused by intracranial occlusion of a large artery is treated with thrombectomy. The Erasmus MC Stroke Centre has initiated a RCT in the Netherlands to prove the beneficial effects of EVT on functional outcome as compared to best medical treatment. Currently, new trials will start which evaluate improvements of EVT, extension of indications and causes of EVT failure.

Principal InvestigatorA van der Lugt
Co-InvestigatorsD Bos, DWJ Dippel,  ACGM van Es, OH Franco, PJ Koudstaal, WJ  Niessen, HJ Verhagen, MW Vernooij
PhD candidatesMJ Berghout-van Gils, QJA van den Bouwhuijsen, CJ Compagne, T Zadi, R van de Graaf, HK van Dam-Nolen, L Wolff, P Homburg