Evaluation of carotid stenosis with axial high-resolution black-blood MR imaging.
High-resolution axial black-blood MR imaging (BB MRI) has been shown to be able to characterise carotid plaque morphology. The aim of this study was to explore the accuracy of this technique in quantifying the severity of carotid stenosis. A prospective study of 54 patients with symptomatic carotid disease was conducted, comparing BB MRI to the gold standard, conventional digital subtraction X-ray angiography (DSA). The BB MRI sequence was a fast-spin echo acquisition (TE = 42 ms, ETL = 24, field of view = 100 x 100 mm, slice thickness = 3.0 mm) at 1.5 T using a custom-built phased-array coil. Linear measurements of luminal and outer carotid wall diameter were made directly from the axial BB MRI slices by three independent blinded readers and stenosis was calculated according to European Carotid Surgery Trial (ECST) criteria. There was good agreement between BB MRI and DSA (intraclass correlation = 0.83). Inter-observer agreement was good (average kappa = 0.77). BB MRI was accurate for detection of severe stenosis (> or = 80%) with sensitivity and specificity of 87 and 81%, respectively. Eight cases of "DSA-defined" moderate stenosis were overestimated as severe by BB MRI and this may be related to non-circular lumens. Axial imaging with BB MRI could potentially be used to provide useful information about severity of carotid stenosis.
University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
Jean M
JM
U-King-Im
Rikin A
RA
Trivedi
Evis
E
Sala
Martin J
MJ
Graves
Mathew
M
Gaskarth
Nicholas J
NJ
Higgins
Justin C
JC
Cross
William
W
Hollingworth
Richard A
RA
Coulden
Peter J
PJ
Kirkpatrick
Nagui M
NM
Antoun
Jonathan H
JH
Gillard
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity