Carotid Plaque Characterization Using 3D T1-Weighted MR Imaging with Histopathologic Validation: A Comparison with 2D Technique

Narumi, Shinsuke; Sasaki, Makoto; Natori, Tatsunori; Oura, Mao Yamaguchi; Ogasawara, Kuniaki; Kobayashi, Masatoshi; Sato, Yuiko; Ogasawara, Yasushi; Hitomi, Jiro; Terayama, Yasuo

doi:10.3174/ajnr.a4197

Cited by 25 publications

(27 citation statements)

References 23 publications

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“…In the present study, 2D axial images perpendicular to the long axis of the common carotid artery and the ICA were generated from 3D imaging data. These methods may be suitable for the assessment of carotid plaques because the carotid artery is tortuous and the plaques are typically elongated in a superoinferior direction [5]. While several investigators have measured plaque intensity on the axial image slice with the greatest degree of carotid stenosis [1,3,4,18,19], others have measured plaque intensity on the image slice with the highest plaque intensity [20,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Of various two-dimensional (2D) T1-weighted sequences for MR plaque imaging, the spin echo (SE) T1-weighted imaging (WI) technique, with appropriate scanning parameters, is the most accurate for quantifying intraplaque components [1,2,3,4]. However, a three-dimensional (3D) fast spin-echo (FSE) T1-WI technique capable of minimizing partial volume effects and motion artifacts, enhancing black-blood effects, and maintaining T1-WI contrast has recently been adopted [5]. A comparison of diagnostic accuracy between 2D SE T1-WI and 3D FSE T1-WI for carotid plaque characterization using pathologic specimens excised from carotid endarterectomy (CEA) was performed.…”

Section: Introductionmentioning

confidence: 99%

“…A comparison of diagnostic accuracy between 2D SE T1-WI and 3D FSE T1-WI for carotid plaque characterization using pathologic specimens excised from carotid endarterectomy (CEA) was performed. It was shown that, because it provides improved contrast of lipid-rich plaques, 3D FSE T1-WI could characterize carotid plaque composition more accurately than 2D SE T1-WI [5]. In addition, 3D FSE T1-WI could differentiate vulnerable from stable plaques with excellent sensitivity and specificity [5].…”

Section: Introductionmentioning

confidence: 99%

“…It was shown that, because it provides improved contrast of lipid-rich plaques, 3D FSE T1-WI could characterize carotid plaque composition more accurately than 2D SE T1-WI [5]. In addition, 3D FSE T1-WI could differentiate vulnerable from stable plaques with excellent sensitivity and specificity [5]. …”

Section: Introductionmentioning

confidence: 99%

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Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy

Ogasawara

Sato

Narumi

et al. 2016

IJMS

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The aim of the present study was to determine whether preoperative three-dimensional (3D) fast spin-echo (FSE) T1-weighted magnetic resonance (MR) plaque imaging for severely stenotic cervical carotid arteries could accurately predict the development of artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). Seventy-five patients underwent preoperative MR plaque imaging and CEA under transcranial Doppler ultrasonography of the ipsilateral middle cerebral artery. On reformatted axial MR image slices showing the maximum plaque occupation rate (POR) and maximum plaque intensity for each patient, the contrast ratio (CR) was calculated by dividing the internal carotid artery plaque signal intensity by the sternocleidomastoid muscle signal intensity. For all patients, the area under the receiver operating characteristic curve (AUC)—used to discriminate between the presence and absence of microembolic signals—was significantly greater for the CR on the axial image with maximum plaque intensity (CRmax intensity) (0.941) than for that with the maximum POR (0.885) (p < 0.05). For 32 patients in whom both the maximum POR and the maximum plaque density were identified, the AUCs for the CR were 1.000. Preoperative 3D FSE T1-weighted MR plaque imaging accurately predicts the development of artery-to-artery emboli during exposure of the carotid arteries in CEA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy

Ogasawara

Sato

Narumi

et al. 2016

IJMS

View full text Add to dashboard Cite

show abstract

“…The signal intensity ratio relative to the ipsilateral sternocleidomastoid muscle (plaque/muscle ratio) was calculated, and high intensity was defined as a plaque/muscle ratio >2 19) . Plaque characteristics were classified into 3 categories: 1) fibrous tissue, 2) lipid/ necrotic core, and 3) intra-plaque hemorrhage 4) (Figure 1).…”

Section: Mri Imagingmentioning

confidence: 99%

Circulating Levels of High-sensitivity C-reactive protein are Associated with Intra-plaque Neovascularization and Intra-plaque Hemorrhage as Evaluated by Contrast-enhanced Ultrasonography and Magnetic Resonance Imaging

Ogura

Shimizu

Hoshino

et al. 2016

J St. Marianna Univ

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Background: Intra-plaque hemorrhage in carotid atheromatous plaque is a recognized high-risk state for ischemic events. Intra-plaque neovascularization can now be visualized by contrast-enhanced carotid ultrasonography (CEUS). These neovessels appear prone to rupture and may be a marker for high-risk of intra-plaque hemorrhage. This study aimed to investigate relationships among circulating biomarkers associated with carotid plaque instability and the presence of intra-plaque hemorrhage on magnetic resonance imaging (MRI) and intraplaque neovascularization on CEUS in patients with advanced atherosclerotic plaques. Methods: Fifty-one patients with mild to severe carotid stenosis were prospectively enrolled, and carotid ultrasonography, CEUS, and MRI were performed. Circulating levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), pentraxin 3 (PTX3), myeloperoxidase (MPO), matrix metalloproteinase (MMP)-9, and high-sensitivity-C-reactive protein (hs-CRP) were also measured. Results: Carotid plaques were categorized into 3 groups based on MRI findings: fibrous tissue, n=13; lipid/ necrotic core, n=30; and intra-plaque hemorrhage, n=8. Regarding plaque echogenicity, 24 plaques were hypoechoic, and 27 were non-hypoechoic. Intra-plaque neovascularization on CEUS was observed in 14 plaques. Multivariate logistic regression analysis identified hypoechoic plaque (odds ratio, 63.126; 95% confidence interval, 1.102-3616.91) and serum hs-CRP (1.064; 1.002-1.130) as factors significantly associated with intra-plaque hemorrhage. Hypoechoic plaque (30.362; 2.462-374.37), and serum hs-CRP (1.066; 1.003-1.132) were revealed as factors significantly associated with intra-plaque neovascularization. Conclusions: Hypoechoic plaque and hs-CRP levels were identified as common predictors of intra-plaque hemorrhage and intra-plaque neovascularization. Longitudinal studies are warranted to clarify the roles of intra-plaque neovascularization on CEUS and hs-CRP levels in intra-plaque hemorrhage and ischemic stroke.

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Visualization of carotid vessel wall and atherosclerotic plaque: T1-SPACE vs. compressed sensing T1-SPACE

et al. 2018

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SPACE allowed better visualization compared with T1-SPACE in evaluating carotid plaques and vessel walls with a 2.5-fold accelerated scan time with comparable image quality. 2. CS-T1-SPACE offers a promising method for investigating carotid vessel walls due to the better image quality with shorter acquisition time. 3. Physiological movements such as swallowing, arterial pulsations, and breathing induce motion artifacts in vessel wall imaging, and a shorter acquisition time can reduce artifacts from physiological movements.

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Carotid Plaque Characterization Using 3D T1-Weighted MR Imaging with Histopathologic Validation: A Comparison with 2D Technique

Cited by 25 publications

References 23 publications

Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy

Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy

Circulating Levels of High-sensitivity C-reactive protein are Associated with Intra-plaque Neovascularization and Intra-plaque Hemorrhage as Evaluated by Contrast-enhanced Ultrasonography and Magnetic Resonance Imaging

Visualization of carotid vessel wall and atherosclerotic plaque: T1-SPACE vs. compressed sensing T1-SPACE

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