Biomechanics and MR Atherosclerosis Imaging for the vulnerability assessment
(BRAIN-I Study)

Introduction: Stroke is a leading cause of mortality and morbidity in the UK and China. Carotid atherosclerotic diseases are responsible for a significant proportion of stroke victims. Numerous studies have shown the limitation of current degree of stenosis-based criterion for clinical decision making, and plaque morphological and compositional features depicted by magnetic resonance (MR) and its mechanical environment are more relevant with patient clinical presentation and subsequent ischaemic events. However the accuracy and reproducibility of MR findings using 3D sequences have not yet been assessed by a multi-centre study. Moreover, the correlation between the material property of atherosclerotic tissue including its mechanics loading and MR findings has not been investigated.

Aims: To identify the optimal magnetic resonance (MR) sequence combination in quantifying carotid atherosclerotic components, and its accuracy and reproducibility; To quantify the material property and strength of atherosclerotic tissues with in vivo MR findings.

Methods: Patients diagnosed for carotid endarterectomy (CEA) will be recruited for this study. Prior to CEA, patients will be scanned using 3D isotropic MR sequences. Plaque samples during CEA will be collected for histopathological analysis and material testing.

Anticipated results: This will be the first clinical study to validate the accuracy and reproducibility of 3D MR sequences in identifying carotid atherosclerotic components and it is also the first study to assess the quantitative relationship between material properties of various atherosclerotic components and MR findings.

Participants and key team members

All team members must have a valid GCP certificate.

 1. Addenbrooke’s Hospital, University of Cambridge, Cambridge, UK (the leading institution in UK)

 2. Beijing Tian Tan Hospital, Capital Medical University, Beijing, China (the leading institution in China)

 3. Chinese PLA general Hospital, Medical School of Chinese PLA, Beijing, China

 4. Changhai Hospital, Shanghai, China

 5. Huashan Hospital, Fudan University, Shanghai, China

 6. Hangzhou Traditional Chinese Medicine Hospital, Hangzhou, Zhejiang, China

 7. Taihe Hospital, Shiyan, Hubei, China


 1. Jingsan Medical Science and Technology (Shanghai) Ltd., China

 2. Tenoke Ltd., Cambridge, UK

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