In Vivo Quantitative Measurement of Intact Fibrous Cap and Lipid-Rich Necrotic Core Size in Atherosclerotic Carotid Plaque

Abstract

Background-Previous studies with contrast-enhanced magnetic resonance imaging (CEMRI) have shown that the fibrous cap (FC) in atherosclerotic carotid plaques enhances with gadolinium-based contrast agents. Conversely, the lipid-rich necrotic core (LR-NC), lacking both vasculature and matrix, shows no or only slight enhancement. The goal of this study was to assess whether CEMRI can be used to accurately measure the dimensions of the intact FC and LR-NC. Methods and Results-Twenty-one patients scheduled for carotid endarterectomy were imaged with a 1.5-T scanner.Precontrast images and CEMRI were obtained. One hundred eight locations with an intact FC were matched between MRI and the excised histology specimens. Quantitative measurements of FC length along the lumen circumference, FC area, and LR-NC area were collected from CEMRI images and histology sections.

Study of reproducibility of human arterial plaque reconstruction and its effects on stress analysis based on multispectral in vivo magnetic resonance imaging

“…The mean value of the difference for lipid core thickness is 1.4 pixel, with a standard deviation of around 0.9 pixel; the disagreement on lipid core area is about 5.2 mm 2 between different investigators. It is worth mentioning that the mean lipid core area difference and standard deviation is in the same range as the difference between MRI and histology measurements (16). The differences in fibrous cap thickness obtained by different investigators are around one pixel, with a standard deviation about 0.95 pixel.…”

“…However, measurement uncertainties become significant when attempting to define a thin plaque fibrous cap, with a thickness at one pixel size, ie, 0.39 mm or less, which is common for a vulnerable plaque. Cai et al (16) quantitatively measured the fibrous cap and lipid-rich necrotic core size with in vivo MRI and compared this with histology data. The MR images and histology slices showed moderate to good agreement for the fibrous cap length and area and the lipid core area.…”

Carotid atherosclerotic plaque characterisation by measurement of ultrasound sound speed in vitro at high frequency, 20MHz

“…Indeed using pre-and post-contrast T1-weighted images, measurement of the lipid core as a proportion of the vessel was shown to be similar on MR images and histology (Cai et al 2005a). Presence of intraplaque haemorrhage was shown to accelerate plaque progression over an 18 month period (Takaya et al 2005).…”

“…The use of Gadolinium-based contrast agent in MRI has improved the distinction between the cap and the lipid core (Cai et al 2005b;Yuan et al 2002a) MRI has also been used to analyse plaque structure. In major commercial engineering projects, determination of the fatigue and durability of a structure can be achieved with great accuracy by the use of finite element analysis (FEA), where a complex mathematical model of the structure is tested to virtual destruction by computerised manipulation of the forces involved.…”

Negative Carotid Artery Remodeling in Early Type 2 Diabetes Mellitus and Increased Carotid Plaque Vulnerability in Obesity as Assessed by Magnetic Resonance Imaging

“…Carotid magnetic resonance imaging (MRI) enables detailed noninvasive high‐resolution images of the carotid arterial wall and allows accurate characterization of the plaque composition. Carotid MRI plaque assessment has been validated by comparison with histological assessment of carotid endarterectomy samples 12, 13, 14, 15, 16, 17, 18. In patients with carotid atherosclerotic disease, the presence of carotid intraplaque hemorrhage, a lipid‐rich necrotic core, and thinned or ruptured fibrous cap detected by MRI is associated with increased risk of future stroke or transient ischemic attack 19.…”