Comparison of lipid-rich necrotic core size in symptomatic and asymptomatic carotid atherosclerotic plaque: Initial results.
OBJECTIVE
To investigate the potential difference in the size of the lipid-rich necrotic core (LRNC) in carotid plaques of symptomatic patients versus asymptomatic patients. Pathological studies established that a large LRNC is an important feature of vulnerable atherosclerotic plaque. Previously, we have demonstrated a high correlation between semiquantitative analysis of the LRNC size in T1-weighted (w) turbo field echo (TFE) MR images and histology.


METHODS
Thirty-seven patients with carotid stenosis >70% with (n = 26) or without (n = 11) symptoms were included. Three independent MR readers quantified the amount of LRNC with a T1w TFE pulse sequence. The relative amount of LRNC (LRNC score) was defined as sum of cross-sectional area percentages LRNC per carotid plaque.


RESULTS
Interreader agreement for the three MR readers was good, with an intraclass correlation coefficient (ICC, 95% confidence interval [CI]) of 0.72 (0.57-0.83). All three MR readers on average found a larger LRNC in the symptomatic group of patients, although this was not statistically significant. The mean LRNC score was 116 +/- 129 and 59 +/- 62 for symptomatic and asymptomatic patients, respectively (P = 0.13). Symptomatic patients showed wide ranges in LRNC scores (0-424), while the range was much lower in the asymptomatic group (0-170).


CONCLUSIONS
Single-sequence T1w TFE may be a promising technique to study atherosclerotic plaque at risk of stroke. Larger studies are warranted to confirm these promising results.
Cappendijk
Vincent C
VC
University Hospital Maastricht, Department of Radiology, Maastricht, The Netherlands. vca@rdia.azm.nl
Kessels
Alfons G H
AG
Heeneman
Sylvia
S
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; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008055:Lipids; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012307:Risk Factors
D008055:Lipids