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High signal intensity halo around the carotid artery on maximum intensity projection images of time‐of‐flight MR angiography: A new sign for intraplaque hemorrhage
Author(s) -
Yim Yoo Jeong,
Choe Yeon Hyeon,
Ko Yonghyeh,
Kim Sung Tae,
Kim Keon Ha,
Jeon Pyoung,
Byun Hong Sik,
Kim DongIk
Publication year - 2008
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.21284
Subject(s) - medicine , radiology , maximum intensity projection , carotid endarterectomy , halo sign , angiography , carotid arteries , magnetic resonance angiography , intensity (physics) , magnetic resonance imaging , nuclear medicine , stenosis , computed tomography , physics , quantum mechanics
Purpose To evaluate the value of the high signal intensity halo sign as a new marker of a fresh or recent intraplaque hemorrhage on the maximum intensity projection (MIP) images of time‐of‐flight (TOF) MR angiography. Materials and Methods A total of 135 consecutive patients were included in this study. High‐resolution MRI using 3‐inch surface coils was performed on a 1.5T scanner before the carotid endarterectomy. TOF MR angiograms and T2‐weighted, T1‐weighted pre‐ and postcontrast fast spin echo images were obtained. The surgical and pathological findings of the carotid artery were analyzed and correlated with the MRI findings. Results A total of 42 atheromas (31.1%) had a fresh or recent intraplaque hemorrhage on the surgicopathological findings. A total of 38 (90.5%) of these patients showed high signal intensity halo around the carotid artery on the MIP images of TOF MR angiography. The high signal intensity halo sign, compared with the surgical and histopathological findings, demonstrated a sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 83%, 72%, and 95%, respectively, with a 95% confidence interval (CI) in the detection of an intraplaque hemorrhage. The multisequence approach suggested the presence of an intraplaque hemorrhage with a sensitivity, specificity, positive predictive value, and negative predictive value of 93%, 85%, 74%, and 96%, respectively, with a 95% CI. Conclusion High signal intensity halo around the carotid artery on the MIP images of TOF MR angiography is useful in the noninvasive detection of a fresh or recent carotid intraplaque hemorrhage. J. Magn. Reson. Imaging 2008;27:1341–1346. © 2008 Wiley‐Liss, Inc.