Background
Magnetic resonance imaging is widely used to evaluate the intraplaque components of
the cervical carotid artery. The non–gated T1-weighted spin-echo (SE) technique has
been reported to have an excellent ability for discriminating stable and unstable
plaques. However, the diagnostic performance of various SE-based techniques remains
unclear. Hence, we compared plaque signals obtained by 3 kinds of SE-based methods
with histological findings.
Methods
We prospectively examined 40 patients who underwent carotid endarterectomy by using
1.5-T scanners and obtained 2-dimensional (2D) conventional spin-echo (CSE), 2D fast
spin-echo (FSE), and 3-dimensional (3D)-FSE images with identical repetition times.
We calculated contrast ratios (CRs) of the plaques against adjacent muscles and compared
these values with the pathological classification of the specimens.
Results
The CRs of type VII-VIII (calcific/fibrous), IV-V (lipid-rich/necrotic), and VI (complex/hemorrhagic)
plaques were significantly different between all the methods (P < .001) and were discriminated from each other at sensitivities of 83%-100% and specificities
of 94%-100%. The CRs of type IV-V plaques significantly differed between the methods
(low to high, 2D-FSE, 2D-CSE, and 3D-FSE; P < .05); those of the type VI plaques were significantly lower with the 2D-FSE method
than with the other methods (P < .01).
Conclusions
The SE-based T1-weighted images can readily discriminate plaque characteristics with
high sensitivities and specificities, although the signal intensity of unstable plaques
was significantly high on the 3D-FSE images and significantly low on the 2D-FSE images.
Key Words
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Article info
Publication history
Published online: November 09, 2016
Accepted:
September 11,
2016
Received in revised form:
August 29,
2016
Received:
July 6,
2016
Footnotes
Grant support: This work was partly supported by JSPS KAKENHI (25861122) and Grant-in-Aid for Strategic Medical Science Research (S1491001) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
Conflict of interest: M.S. is a consultant for Hitachi Medical Corporation and has received honoraria from Hitachi Medical Corporation.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.017
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
