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In vivo accuracy of multisequence MR imaging for identifying unstable fibrous caps in advanced human carotid plaques
Author(s) -
Mitsumori Lee M.,
Hatsukami Thomas S.,
Ferguson Marina S.,
Kerwin William S.,
Cai Jianming,
Yuan Chun
Publication year - 2003
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.10264
Subject(s) - fibrous cap , in vivo , medicine , lumen (anatomy) , magnetic resonance imaging , radiology , pathology , surgery , biology , microbiology and biotechnology
Purpose To evaluate the in vivo accuracy of a multisequence MRI technique for prospectively identifying one feature of the vulnerable plaque—an unstable fibrous cap—in human carotid atherosclerosis. Materials and Methods The carotid arteries of 18 endarterectomy patients were preoperatively imaged in a 1.5T scanner using a multisequence protocol that generated four contrast weightings (3D time of flight (ToF), T1, proton density (PD), and T2) at each slice location. With the use of previously published MR criteria, the images of the vessel wall were first examined for evidence of an unstable fibrous cap. The imaging findings were then correlated with the histology from the surgical specimens. Results A blinded review of the MR findings with the histologic state of the fibrous cap revealed that 1) assessing the preoperative appearance of the fibrous cap has a high test sensitivity (0.81) and specificity (0.90) for identifying an unstable cap in vivo; and 2) the availability of different contrast weightings facilitated image interpretation when intimal calcifications or flow artifacts obscured the lumen surface. Conclusion Multisequence MRI can accurately characterize the in vivo state of the fibrous cap. This finding supports the use of these noninvasive techniques to prospectively identify vulnerable plaques. J. Magn. Reson. Imaging 2003;17:410–420. Published 2003 Wiley‐Liss, Inc.