| High-Resolution MRI of Carotid Plaque With a Neurovascular Coil and Contrast-Enhanced MR Angiography: One-Stop Shopping for the Comprehensive Assessment of Carotid Atherosclerosis. | |
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MedLine Citation:
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PMID: 21512087 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of our study was to assess a protocol of study of carotid atherosclerosis coupling vascular wall imaging and luminal imaging in the same examination and to evaluate the accuracy of high-resolution MRI with a neurovascular coil in carotid plaque characterization. SUBJECTS AND METHODS: Thirty-two consecutive patients with 34 carotid artery stenoses were prospectively enrolled. MRI was performed on a 1.5-T unit. Plaque assessment was performed starting with a diffusion-weighted sequence and followed by a fat-suppressed T1-weighted sequence; after contrast-enhanced MR angiography (CE-MRA), all patients were evaluated with a T1-weighted 3D high-resolution sequence. Carotid plaques were classified as type A, having a large lipid-necrotic core; type B, being a complex fibrotic-calcified plaque with soft content (mixed plaque); or type C, being a fibrotic-calcified plaque (hard). Additional features indicative of vulnerable plaque such as intraplaque hemorrhage (IPH), ulceration, and severe stenosis were registered. MR findings were compared with surgical specimens. RESULTS: MRI correctly identified 11 of 13 type A, eight of 11 type B, and eight of 10 type C plaques (sensitivity, 84.6%, 72.7%, and 80%, respectively). In the identification of lipid-necrotic core plaque, MRI showed a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 84.6%, 100%, 100%, and 91.3%, respectively (κ = 0.87). For reordering all plaques in two groups (i.e., soft vs nonsoft) in the identification of soft plaques, MRI had a sensitivity, specificity, PPV, and NPV of 83.3%, 80%, 90.9%, and 66.7%, respectively (κ = 0.59). IPH, ulcers, and severe stenosis were detected in eight of eight, 11 of 13, and 25 of 25 cases, respectively. CONCLUSION: In patients with carotid atherosclerosis, ongoing CE-MRA with a neurovascular coil for the simultaneous detection of unstable plaques is feasible. Our MR protocol accurately identifies the major features of vulnerable plaque. |
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Authors:
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Stefano Tartari; Roberto Rizzati; Riccardo Righi; Anna Deledda; Katia Capello; Riccardo Soverini; Giorgio Benea |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 196 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 1164-71 Citation Subset: AIM; IM |
Affiliation:
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Dipartimento di Radiologia Clinica Diagnostica ed Interventistica, Azienda USL Ferrara, Via Cassoli 30, 44100 Ferrara, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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