Comparison of single-sequence T1w TFE MRI with multisequence MRI for the quantification of lipid-rich necrotic core in atherosclerotic plaque.
OBJECTIVE
To prospectively determine the accuracy of semiquantitative analysis of the amount of lipid-rich necrotic core (LRNC) in atherosclerotic plaque using multi- as well as single-sequence T1-weighted (w) turbo field echo (TFE) MRI. Histology served as a reference standard.


METHODS
Sixty-four symptomatic patients with carotid stenosis > or =70% were included and underwent endarterectomy after an MRI scan. Two MRI readers classified relative signal intensities in regions of interest in the vessel wall. The amount of LRNC was determined semiquantitatively using an algorithm based on fixed combinations of multiple MR pulse sequences as well as solely based on T1w TFE images. Interreader agreement was expressed by intraclass correlation coefficients (ICCs). Agreement between MRI and histology was determined by linear regression (R).


RESULTS
Interreader reproducibility for quantification of LRNC was high (ICC, 95% confidence interval [CI]): multisequence 0.86 (0.77-0.94), and single sequence 0.91 (0.85-0.95). There was good agreement between MRI and histology for both MR readers for quantification based on multisequence as well as single sequence MRI, 0.80 < or = R < or = 0.85 (P < 0.0001).


CONCLUSIONS
The amount of LRNC using single-sequence T1w TFE MRI is a reproducible, accurate, and fast way to quantify LRNC in carotid atherosclerotic plaque.
Cappendijk
Vincent C
VC
Department of Radiology, Maastricht University Hospital, Maastricht, The Netherlands. vca@rdia.azm.nl
Heeneman
Sylvia
S
Kessels
Alfons G H
AG
Cleutjens
Kitty B J M
KB
Schurink
Geert Willem H
GW
Welten
Rob J Th J
RJ
Mess
Werner H
WH
van Suylen
Robert-Jan
RJ
Leiner
Tim
T
Daemen
Mat J A P
MJ
van Engelshoven
Jos M A
JM
Kooi
M Eline
ME
D000368:Aged; D000465:Algorithms; D001161:Arteriosclerosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002339:Carotid Arteries / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008055:Lipids / Q000032:analysis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009336:Necrosis; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D008055:Lipids