title: Evaluation of inflammatory status of atherosclerotic carotid plaque before thromboendarterectomy using delayed contrast-enhanced subtracted images after magnetic resonance angiography.
abstract: OBJECTIVE
  To investigate the correlation among carotid plaque contrast enhancement (CPCE) at MRI, inflammatory cell infiltration (ICI) at histopathology, and carotid stenosis degree.
  
  
  METHODS
  Twenty-eight patients (19 males; mean age 67±9 years) scheduled for thromboendarterectomy prospectively underwent 1.5-T MR imaging using: (a) axial T1-weighted gradient-echo (T1wGRE) sequence centered on carotid bifurcations; (b) contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine; (c) enhanced axial T1wGRE sequence as in (a), 3 min after contrast injection. A three-point score system (absent, focal, wide) was used to assess CPCE on native and subtracted MRI images (c minus a) and ICI at histopathology. Carotid stenosis degree was determined on CE-MRA.
  
  
  RESULTS
  Six CPCE studies were discarded due to patient movement. In the remaining 22 studies, CPCE was absent, focal and wide in 13, 6 and 3 cases, respectively; ICI was absent, focal and wide in 13, 7 and 2 cases, respectively (k=0.57). On CE-MRA 21/28 stenoses were severe and 7/28 moderate. There was no correlation either with ICI (p=1.000, n=28) or CPCE (p=0.747, n=22).
  
  
  CONCLUSIONS
  The correlation between CPCE and ICI suggests a role for CPCE as an independent marker of plaque inflammation.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy. docgde@gmail.com
authors.forename: Giacomo D E
authors.initials: GD
authors.lastname: Papini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.forename: Stefania
authors.initials: S
authors.lastname: Tritella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nano
authors.forename: Biagio
authors.initials: B
authors.lastname: Cotticelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Clemente
authors.forename: Domenico G
authors.initials: DG
authors.lastname: Tealdi
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D001167:Arteritis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D003287:Contrast Media; D004691:Endarterectomy; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine