5. Conclusions
In this pilot study, we demonstrated that carotid MRI can be reliable in classifying carotid lesions and differentiating unstable from stable plaques. Our initial results showed that the expression of MMP-9 is significantly higher among symptomatic patients undergoing CEA which suggest that MMP-9 may affect remodelling and destabilization of the carotid plaque among symptomatic patients. This study could help in defining discriminative ability of preoperative MRI, and in improving identification of patients with unstable plaque that have an indication for CEA. However, further study will be anticipated with more participants being recruited over a longer study period. Further prospective and randomized studies are needed to provide better understanding of the mechanisms by which MMP-9 can affect atherosclerotic plaque structure and remodelling.