MRI-derived measurements of fibrous-cap and lipid-core thickness: the potential for identifying vulnerable carotid plaques in vivo

Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive...

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Bibliographic Details
Published in:Neuroradiology 2004-09, Vol.46 (9), p.738-743
Main Authors: TRIVEDI, Rikin A, U-KING-IM, Jean-Marie, GRAVES, Martin J, HORSLEY, Jo, GODDARD, Martin, KIRKPATRICK, Peter J, GILLARD, Jonathan H
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Blood vessels
Brain
Carotid Artery, Common - pathology
Carotid Stenosis - pathology
Female
Fibrosis
Humans
Image Processing, Computer-Assisted
Investigative techniques, diagnostic techniques (general aspects)
Lipids
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Nervous system
Neurology
NMR
Nuclear magnetic resonance
Predictive Value of Tests
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Rupture, Spontaneous - pathology
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Summary:Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive patients scheduled for carotid endarterectomy underwent pre-operative in vivo multi-sequence MR imaging of the carotid artery. Individual plaque constituents were characterised on MR images. Fibrous-cap and lipid-core thickness was measured on MRI and histology images. Bland-Altman plots were generated to determine the level of agreement between the two methods. Multi-sequence MRI identified 133 corresponding MR and histology slices. Plaque calcification or haemorrhage was seen in 47 of these slices. MR and histology derived fibrous cap-lipid-core thickness ratios showed strong agreement with a mean difference between MR and histology ratios of 0.02 (+/- 0.04). The intra-class correlation coefficient between two readers for measurements was 0.87 (95% confidence interval, 0.73 and 0.93). Multi-sequence, high-resolution MR imaging accurately quantified the relative thickness of fibrous-cap and lipid-core components of carotid atheromatous plaques. This may prove to be a useful tool to characterise vulnerable plaques in vivo.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-004-1247-6