title: Comparison of single-sequence T1w TFE MRI with multisequence MRI for the quantification of lipid-rich necrotic core in atherosclerotic plaque.
abstract: 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.
authors.affiliation: Department of Radiology, Maastricht University Hospital, Maastricht, The Netherlands. vca@rdia.azm.nl
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Cappendijk
authors.forename: Sylvia
authors.initials: S
authors.lastname: Heeneman
authors.forename: Alfons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Kitty B J M
authors.initials: KB
authors.lastname: Cleutjens
authors.forename: Geert Willem H
authors.initials: GW
authors.lastname: Schurink
authors.forename: Rob J Th J
authors.initials: RJ
authors.lastname: Welten
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Suylen
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.forename: Mat J A P
authors.initials: MJ
authors.lastname: Daemen
authors.forename: Jos M A
authors.initials: JM
authors.lastname: van Engelshoven
authors.forename: M Eline
authors.initials: ME
authors.lastname: Kooi
mesh_terms: 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
chemical_list: D008055:Lipids