AIM:To compare 3D Black Blood turbo spin echo (TSE) sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) vs 2D TSE in evaluating atherosclerotic plaques in multiple vascular territories. METHODS:The carotid, aortic, and femoral arterial walls of 16 patients at risk for cardiovascular or atherosclerotic disease were studied using both 3D black blood magnetic resonance imaging SPACE and conventional 2D multi-contrast TSE sequences using a consolidated imaging approach in the same imaging session. Qualitative and quantitative analyses were performed on the images. Agreement of morphometric measurements between the two imaging sequences was assessed using a two-sample t -test, calculation of the intra-class correlation coefficient and by the method of linear regression and Bland-Altman analyses. RESULTS:No statistically significant qualitative differences were found between the 3D SPACE and 2D TSE techniques for images of the carotids and aorta. For images of the femoral arteries, however, there were statistically significant differences in all four qualitative scores between the two techniques. Using the current approach, 3D SPACE is suboptimal for femoral imaging. However, this may be due to coils not being optimized for femoral imaging. Quantitatively, in our study, higher mean total vessel area measurements for the 3D SPACE technique across all three vascular beds were observed. No significant differences in lumen area for both the right and left carotids were observed between the two techniques. Overall, a significant-correlation existed between measures obtained between the two approaches. Core tip: The traditional approach to atherosclerotic plaque imaging using magnetic resonance (MR) is the two-dimensional (2D) multi-contrast turbo spin echo technique. However, 3D black blood MR imaging is becoming the preferred methodology for evaluating plaque burden non-invasively. Comparing imaging results obtained using both 3D sampling Perfection with application-optimized contrast using different flip angle evolution (SPACE) and conventional 2D multi-contrast TSE sequences in evaluating vascular territories showed good agreement in both qualitative and quantitative measurements between the two techniques. 3D SPACE technique is a promising and potentially feasible approach for the evaluation of multiple vascular beds in patients at risk for cardiovascular disease. CONCLUSION:Wong SK, Mobolaji-Iawal M, Arama L, Cambe J, Biso S, Alie N, Fayad ZA, Mani V. Atherosclerosis imaging using 3D black blood TSE SPACE vs 2D TSE.