An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery | springermedicine.com

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Open Access 01-07-2016 | Neuro

An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery

Authors: Zhongzhao Teng, Wenjia Peng, Qian Zhan, Xuefeng Zhang, Qi Liu, Shiyue Chen, Xia Tian, Luguang Chen, Adam J. Brown, Martin J. Graves, Jonathan H. Gillard, Jianping Lu

Published in: European Radiology | Issue 7/2016

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Abstract

Objective

Although certain morphological features depicted by high resolution, multi-contrast magnetic resonance imaging (hrMRI) have been shown to be different between culprit and non-culprit middle cerebral artery (MCA) atherosclerotic lesions, the incremental value of hrMRI to define culprit lesions over stenosis has not been assessed.

Methods

Patients suspected with MCA stenosis underwent hrMRI. Lumen and outer wall were segmented to calculate stenosis, plaque burden (PB), volume (PV), length (PL) and minimum luminal area (MLA).

Results

Data from 165 lesions (112 culprit and 53 non-culprit) in 139 individuals were included. Culprit lesions were larger and longer with a narrower lumen and increased PB compared with non-culprit lesions. More culprit lesions showed contrast enhancement. Both PB and MLA were better indicators than stenosis in differentiating lesion types (AUC were 0.649, 0.732 and 0.737 for stenosis, PB and MLA, respectively). Combinations of PB, MLA and stenosis could improve positive predictive value (PPV) and specificity significantly. An optimal combination of stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm² produced a PPV = 85.7 %, negative predictive value = 54.1 %, sensitivity = 69.6 %, specificity = 75.5 %, and accuracy = 71.5 %.

Conclusions

hrMRI plaque imaging provides incremental information to luminal stenosis in identifying culprit lesions.

Key points

• High resolution MRI provides incremental information in defining culprit MCA atherosclerotic lesions.

• Both plaque burden and minimum luminal area are better indicators than stenosis.

• An optimal combination includes stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm ² .

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Title: An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery
Authors: Zhongzhao Teng
Wenjia Peng
Qian Zhan
Xuefeng Zhang
Qi Liu
Shiyue Chen
Xia Tian
Luguang Chen
Adam J. Brown
Martin J. Graves
Jonathan H. Gillard
Jianping Lu
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4008-5

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