Quantitative assessment of carotid artery atherosclerosis by three-dimensional magnetic resonance and two-dimensional ultrasound imaging: a comparison study

Abstract

Background: It has been proven that magnetic resonance (MR) and ultrasound imaging are useful tools in the quantification of carotid atherosclerotic plaques. However, there are only a few pieces of evidence to illustrate the links of quantitative measurements of carotid plaques between MR and ultrasound imaging.This study looked to compare the quantitative measurements of carotid plaques and investigate their relationship between three-dimensional (3D) MR vessel wall imaging and two-dimensional (2D) ultrasound imaging.Methods: Seventy-five asymptomatic elderly subjects (mean age: 73.3±5.7 years; 45 males) with carotid atherosclerotic plaques diagnosed by both ultrasound and MR imaging were included in this study. The plaque size, including the maximum wall thickness (Max WT), plaque length, and plaque area, was measured by 3D MR and ultrasound imaging on longitudinal and cross-sectional views. The quantitative assessments of carotid plaque size were compared and correlated between 3D MR and 2D ultrasound imaging.Results: In total, the quantitative measurements of 101 plaques on longitudinal views or 44 plaques on cross-sectional views of both MR and ultrasound imaging were compared. The Max WT of the plaques (longitudinal: 2.9±0.8 vs. 2.4±0.9 mm; cross-sectional: 3.2±1.1 vs. 2.6±0.7 mm) and plaque areas (longitudinal: 24.3±13.4 vs. 17.0±12.7 mm 2 ; cross-sectional: 24.9±24.6 vs. 16.8±13.3 mm 2 ) measured by MR imaging were found to be significantly higher than those measured by ultrasound imaging (all P<0.001). Moderate to strong correlations were found in Max WT, plaque area, plaque length between 3D MR and ultrasound imaging. Conclusions:The quantitative measurements of carotid plaques using 3D MR and 2D ultrasound are significantly correlated. The plaque area and Max WT measured by 3D MR imaging are more significant than these parameters measured by 2D ultrasound imaging, which might be explained by the resolution of MR imaging and the workflow of measurements.

Imaging diagnosis and research progress of carotid plaque vulnerability

“…Three‐dimensional ultrasound (3D‐US) is a new technique developed in recent years and has attracted much attention by presenting the three‐dimensional stereostructure of the target. Three‐dimensional ultrasound presents an objective three‐dimensional image of the target, which has advantages such as intuitiveness and reproducibility 21 . The current state‐of‐the‐art 3D‐US scanning technology is automated single scan, which obtains three‐dimensional images by a single scan to target the most realistic three‐dimensional morphological display, overcoming the early shortcomings of poor reproducibility of 3D‐US images.…”

“…Threedimensional ultrasound presents an objective three-dimensional image of the target, which has advantages such as intuitiveness and reproducibility. 21 The current state-of-the-art 3D-US scanning technology is automated single scan, which obtains three-dimensional images by a single scan to target the most realistic three-dimensional morphological display, overcoming the early shortcomings of poor reproducibility of 3D-US images. In addition, single scan techniques automatically slice at 1.0 mm intervals to measure volume, and plaque volumes measured by this method are more accurate than 2D-US.…”

Added value of femoral artery atherosclerosis for determining severity of white matter lesion by carotid atherosclerosis: a magnetic resonance imaging study

“…In clinical settings, ultrasound imaging is a widely used screening tool for both carotid and femoral artery plaques. A recent comparison study between ultrasound and vessel wall MRI showed that moderate to strong correlations can be found in maximum wall thickness, plaque area, and plaque length between 3D vessel wall MRI and ultrasound imaging (28). Although ultrasound imaging has limitations in characterizing the vulnerability of atherosclerotic plaques, particularly plaque compositional feature of intraplaque hemorrhage, this imaging modality can well detect lipid-rich plaques according to the presence of echolucent components (29).…”

Interrogating Atherosclerotic Plaque Biology Through Responses to Cardiovascular Risk Management and Imaging

“…In carotid MR there is extensive literature describing plaque composition and imaging techniques, but the minimum criteria for plaque size are utterly vague. In practice, criteria used in ultrasonography are frequently used in carotid MRI (26). The author's own experience, based on MR imaging of patients with advanced atherosclerosis, is that plaques are difficult to delineate because the atherosclerotic changes usually affect the entire arterial wall stretching over centimetre-long segments, not in the form of protruding plaques with clearly delineated start-and end points.…”