T1-Weighted Magnetic Resonance Carotid Plaque Imaging: a Comparison between Conventional and Fast Spin-Echo Techniques

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• 作者：Shinsuke Narumi ; MD ; PhD^* ; ^{snarumi@iwate-med.ac.jp} ; Makoto Sasaki ; MD ; PhD^&dagger ; ; Haruna Miyazawa ; MD^* ; Tatsunori Natori ; MD ; PhD^* ; Kohei Ito ; MD^* ; Kuniaki Ogasawara ; MD ; PhD^&Dagger ; ; Masakazu Kobayashi ; MD ; PhD^&Dagger ; ; Jiro Hitomi ; MD ; PhD^§ ; ; Yasuo Terayama ; MD ; PhD^*
• 关键词：Carotid plaque ; magnetic resonance imaging ; T1-weighted image ; carotid endarterectomy
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：26
• 期：2
• 页码：273-279
• 全文大小：551 K
• 卷排序：26

文摘

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.MethodsWe 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.ResultsThe 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).ConclusionsThe 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.