Skip to main content
Top
Published in: Neuroradiology 11/2012

01-11-2012 | Diagnostic Neuroradiology

Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study

Authors: Ayumi Saito, Makoto Sasaki, Kuniaki Ogasawara, Masakazu Kobayashi, Jiro Hitomi, Shinsuke Narumi, Hideki Ohba, Mao Yamaguchi, Kohsuke Kudo, Yasuo Terayama

Published in: Neuroradiology | Issue 11/2012

Login to get access

Abstract

Introduction

Several magnetic resonance (MR) imaging techniques are used to examine atherosclerotic plaque of carotid arteries; however, the best technique for visualizing intraplaque characteristics has yet to be determined. Here, we directly compared four kinds of T1-weighted (T1W) imaging techniques with pathological findings in patients with carotid stenosis.

Methods

A total of 31 patients who were candidates for carotid endarterectomy were prospectively examined using a 1.5-T MRI scanner, which produced four kinds of T1W images, including non-gated spin echo (SE), cardiac-gated black-blood (BB) fast-SE (FSE), magnetization-prepared rapid acquisition with gradient echo (MPRAGE), and source image of three-dimensional time-of-flight MR angiography (SI-MRA). The signal intensity of the carotid plaque was manually measured, and the contrast ratio (CR) against the adjacent muscle was calculated. CRs from the four imaging techniques were compared to each other and correlated with histopathological specimens.

Results

CRs of the carotid plaques mainly containing fibrous tissue, lipid/necrosis, and hemorrhage were significantly different with little overlaps (range: 0.92–1.15, 1.22–1.52, and 1.55–2.30, respectively) on non-gated SE. However, BB-FSE showed remarkable overlaps among the three groups (0.89–1.10, 1.07–1.23, and 1.01–1.42, respectively). MPRAGE could discriminate fibrous plaques from hemorrhagic plaques but not from lipid/necrosis-rich plaques: (0.77–1.07, 1.45–2.43, and 0.85–1.42, respectively). SI-MRA showed the same tendencies (1.01–1.39, 1.45–2.57, and 1.12–1.39, respectively).

Conclusion

Among T1W MR imaging techniques, non-gated SE images can more accurately characterize intraplaque components in patients who underwent CEA when compared with cardiac-gated BB-FSE, MPRAGE, and SI-MRA images.
Literature
1.
go back to reference Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF (2010) Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 363:11–23PubMedCrossRef Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF (2010) Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 363:11–23PubMedCrossRef
2.
go back to reference Yamada K, Yoshimura S, Kawasaki M, Enomoto Y, Asano T, Hara A, Minatoguchi S, Iwama T (2011) Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging. Atherosclerosis 215:399–404PubMedCrossRef Yamada K, Yoshimura S, Kawasaki M, Enomoto Y, Asano T, Hara A, Minatoguchi S, Iwama T (2011) Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging. Atherosclerosis 215:399–404PubMedCrossRef
3.
go back to reference Takaya N, Yuan C, Chu B, Saam T, Underhill H, Cai J, Tran N, Polissar NL, Isaac C, Ferguson MS, Garden GA, Cramer SC, Maravilla KR, Hashimoto B, Hatsukami TS (2006) Association between carotid plaque characteristics and subsequent ischemic cerebrovascular events: a prospective assessment with MRI—initial results. Stroke 37:818–823PubMedCrossRef Takaya N, Yuan C, Chu B, Saam T, Underhill H, Cai J, Tran N, Polissar NL, Isaac C, Ferguson MS, Garden GA, Cramer SC, Maravilla KR, Hashimoto B, Hatsukami TS (2006) Association between carotid plaque characteristics and subsequent ischemic cerebrovascular events: a prospective assessment with MRI—initial results. Stroke 37:818–823PubMedCrossRef
4.
go back to reference Yamada N, Higashi M, Otsubo R, Sakuma T, Oyama N, Tanaka R, Iihara K, Naritomi H, Minematsu K, Naito H (2007) Association between signal hyperintensity on T1-weighted MR imaging of carotid plaques and ipsilateral ischemic events. AJNR Am J Neuroradiol 28:287–292PubMed Yamada N, Higashi M, Otsubo R, Sakuma T, Oyama N, Tanaka R, Iihara K, Naritomi H, Minematsu K, Naito H (2007) Association between signal hyperintensity on T1-weighted MR imaging of carotid plaques and ipsilateral ischemic events. AJNR Am J Neuroradiol 28:287–292PubMed
5.
go back to reference Hatsukami TS, Yuan C (2010) MRI in the early identification and classification of high-risk atherosclerotic carotid plaques. Imaging Med 2:63–75PubMedCrossRef Hatsukami TS, Yuan C (2010) MRI in the early identification and classification of high-risk atherosclerotic carotid plaques. Imaging Med 2:63–75PubMedCrossRef
6.
go back to reference Yoshida K, Narumi O, Chin M, Inoue K, Tabuchi T, Oda K, Nagayama M, Egawa N, Hojo M, Goto Y, Watanabe Y, Yamagata S (2008) Characterization of carotid atherosclerosis and detection of soft plaque with use of black-blood MR imaging. AJNR Am J Neuroradiol 29:868–874PubMedCrossRef Yoshida K, Narumi O, Chin M, Inoue K, Tabuchi T, Oda K, Nagayama M, Egawa N, Hojo M, Goto Y, Watanabe Y, Yamagata S (2008) Characterization of carotid atherosclerosis and detection of soft plaque with use of black-blood MR imaging. AJNR Am J Neuroradiol 29:868–874PubMedCrossRef
7.
go back to reference Yoshimura S, Yamada K, Kawasaki M, Asano T, Kanematsu M, Takamatsu M, Hara A (2011) High-intensity signal on time-of-flight magnetic resonance angiography indicates carotid plaques at high risk for cerebral embolism during stenting. Stroke 42:3132–3137PubMedCrossRef Yoshimura S, Yamada K, Kawasaki M, Asano T, Kanematsu M, Takamatsu M, Hara A (2011) High-intensity signal on time-of-flight magnetic resonance angiography indicates carotid plaques at high risk for cerebral embolism during stenting. Stroke 42:3132–3137PubMedCrossRef
8.
go back to reference Watanabe Y, Nagayama M, Suga T, Yoshida K, Yamagata S, Okumura A, Amoh Y, Nakashita S, Van Cauteren M, Dodo Y (2008) Characterization of atherosclerotic plaque of carotid arteries with histopathological correlation: vascular wall MR imaging vs. color Doppler ultrasonography (US). J Magn Reson Imaging 28:478–485PubMedCrossRef Watanabe Y, Nagayama M, Suga T, Yoshida K, Yamagata S, Okumura A, Amoh Y, Nakashita S, Van Cauteren M, Dodo Y (2008) Characterization of atherosclerotic plaque of carotid arteries with histopathological correlation: vascular wall MR imaging vs. color Doppler ultrasonography (US). J Magn Reson Imaging 28:478–485PubMedCrossRef
9.
go back to reference Moody AR, Murphy RE, Morgan PS, Martel AL, Delay GS, Allder S, MacSweeney ST, Tennant WG, Gladman J, Lowe J, Hunt BJ (2003) Characterization of complicated carotid plaque with magnetic resonance direct thrombus imaging in patients with cerebral ischemia. Circulation 107:3047–3052PubMedCrossRef Moody AR, Murphy RE, Morgan PS, Martel AL, Delay GS, Allder S, MacSweeney ST, Tennant WG, Gladman J, Lowe J, Hunt BJ (2003) Characterization of complicated carotid plaque with magnetic resonance direct thrombus imaging in patients with cerebral ischemia. Circulation 107:3047–3052PubMedCrossRef
10.
go back to reference Tamhane AA, Arfanakis K (2009) Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) and turboprop MRI. Magn Reson Med 62:174–182PubMedCrossRef Tamhane AA, Arfanakis K (2009) Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) and turboprop MRI. Magn Reson Med 62:174–182PubMedCrossRef
11.
go back to reference Narumi S, Sasaki M, Ohba H, Ogasawara K, Hitomi J, Mori K, Ohura K, Ono A, Terayama Y (2010) Altered carotid plaque signal among different repetition times on T1-weighted magnetic resonance plaque imaging with self-navigated radial-scan technique. Neuroradiology 52:285–290PubMedCrossRef Narumi S, Sasaki M, Ohba H, Ogasawara K, Hitomi J, Mori K, Ohura K, Ono A, Terayama Y (2010) Altered carotid plaque signal among different repetition times on T1-weighted magnetic resonance plaque imaging with self-navigated radial-scan technique. Neuroradiology 52:285–290PubMedCrossRef
12.
go back to reference Yuan C, Mitsumori LM, Beach KW, Maravilla KR (2001) Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. Radiology 221:285–299PubMedCrossRef Yuan C, Mitsumori LM, Beach KW, Maravilla KR (2001) Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. Radiology 221:285–299PubMedCrossRef
13.
go back to reference Chu B, Kampschulte A, Ferguson MS, Kerwin WS, Yarnykh VL, O'Brien KD, Polissar NL, Hatsukami TS, Yuan C (2004) Hemorrhage in the atherosclerotic carotid plaque: a high-resolution MRI study. Stroke 35:1079–1084PubMedCrossRef Chu B, Kampschulte A, Ferguson MS, Kerwin WS, Yarnykh VL, O'Brien KD, Polissar NL, Hatsukami TS, Yuan C (2004) Hemorrhage in the atherosclerotic carotid plaque: a high-resolution MRI study. Stroke 35:1079–1084PubMedCrossRef
14.
go back to reference Ota H, Yarnykh VL, Ferguson MS, Underhill HR, Demarco JK, Zhu DC, Oikawa M, Dong L, Zhao X, Collar A, Hatsukami TS, Yuan C (2010) Carotid intraplaque hemorrhage imaging at 3.0-T MR imaging: comparison of the diagnostic performance of three T1-weighted sequences. Radiology 254:551–563PubMedCrossRef Ota H, Yarnykh VL, Ferguson MS, Underhill HR, Demarco JK, Zhu DC, Oikawa M, Dong L, Zhao X, Collar A, Hatsukami TS, Yuan C (2010) Carotid intraplaque hemorrhage imaging at 3.0-T MR imaging: comparison of the diagnostic performance of three T1-weighted sequences. Radiology 254:551–563PubMedCrossRef
15.
go back to reference Hishikawa T, Iihara K, Yamada N, Ishibashi-Ueda H, Miyamoto S (2010) Assessment of necrotic core with intraplaque hemorrhage in atherosclerotic carotid artery plaque by MR imaging with 3D gradient–echo sequence in patients with high-grade stenosis. Clinical article. J Neurosurg 113:890–896PubMedCrossRef Hishikawa T, Iihara K, Yamada N, Ishibashi-Ueda H, Miyamoto S (2010) Assessment of necrotic core with intraplaque hemorrhage in atherosclerotic carotid artery plaque by MR imaging with 3D gradient–echo sequence in patients with high-grade stenosis. Clinical article. J Neurosurg 113:890–896PubMedCrossRef
16.
go back to reference Yamaguchi M, Sasaki M, Ohba H, Mori K, Narumi S, Katsura N, Ohura K, Kudo K, Terayama Y (2012) Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging. Neuroradiology [Epub ahead of print] Yamaguchi M, Sasaki M, Ohba H, Mori K, Narumi S, Katsura N, Ohura K, Kudo K, Terayama Y (2012) Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging. Neuroradiology [Epub ahead of print]
17.
go back to reference Balu N, Chu B, Hatsukami TS, Yuan C, Yarnykh VL (2008) Comparison between 2D and 3D high-resolution black-blood techniques for carotid artery wall imaging in clinically significant atherosclerosis. J Magn Reson Imaging 27:918–924PubMedCrossRef Balu N, Chu B, Hatsukami TS, Yuan C, Yarnykh VL (2008) Comparison between 2D and 3D high-resolution black-blood techniques for carotid artery wall imaging in clinically significant atherosclerosis. J Magn Reson Imaging 27:918–924PubMedCrossRef
18.
go back to reference Crowe LA, Gatehouse P, Yang GZ, Mohiaddin RH, Varghese A, Charrier C, Keegan J, Firmin DN (2003) Volume-selective 3D turbo spin echo imaging for vascular wall imaging and distensibility measurement. J Magn Reson Imaging 17:572–580PubMedCrossRef Crowe LA, Gatehouse P, Yang GZ, Mohiaddin RH, Varghese A, Charrier C, Keegan J, Firmin DN (2003) Volume-selective 3D turbo spin echo imaging for vascular wall imaging and distensibility measurement. J Magn Reson Imaging 17:572–580PubMedCrossRef
19.
go back to reference Cappendijk VC, Heeneman S, Kessels AG, Cleutjens KB, Schurink GW, Welten RJ, Mess WH, van Suylen RJ, Leiner T, Daemen MJ, van Engelshoven JM, Kooi ME (2008) Comparison of single-sequence T1w TFE MRI with multisequence MRI for the quantification of lipid-rich necrotic core in atherosclerotic plaque. J Magn Reson Imaging 27:1347–1355PubMedCrossRef Cappendijk VC, Heeneman S, Kessels AG, Cleutjens KB, Schurink GW, Welten RJ, Mess WH, van Suylen RJ, Leiner T, Daemen MJ, van Engelshoven JM, Kooi ME (2008) Comparison of single-sequence T1w TFE MRI with multisequence MRI for the quantification of lipid-rich necrotic core in atherosclerotic plaque. J Magn Reson Imaging 27:1347–1355PubMedCrossRef
20.
go back to reference Underhill HR, Yarnykh VL, Hatsukami TS, Wang J, Balu N, Hayes CE, Oikawa M, Yu W, Xu D, Chu B, Wyman BT, Polissar NL, Yuan C (2008) Carotid plaque morphology and composition: initial comparison between 1.5- and 3.0-T magnetic field strengths. Radiology 248:550–560PubMedCrossRef Underhill HR, Yarnykh VL, Hatsukami TS, Wang J, Balu N, Hayes CE, Oikawa M, Yu W, Xu D, Chu B, Wyman BT, Polissar NL, Yuan C (2008) Carotid plaque morphology and composition: initial comparison between 1.5- and 3.0-T magnetic field strengths. Radiology 248:550–560PubMedCrossRef
Metadata
Title
Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study
Authors
Ayumi Saito
Makoto Sasaki
Kuniaki Ogasawara
Masakazu Kobayashi
Jiro Hitomi
Shinsuke Narumi
Hideki Ohba
Mao Yamaguchi
Kohsuke Kudo
Yasuo Terayama
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 11/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-012-1025-9

Other articles of this Issue 11/2012

Neuroradiology 11/2012 Go to the issue