title: [Oblique-sagittal black-blood contrast-enhanced magnetic resonance imaging in preoperative evaluation for carotid endarterectomy].
abstract: OBJECTIVE
  To evaluate the value of oblique-sagittal black-blood contrast-enhanced magnetic resonance imaging (OB-CEMRI) in atherosclerotic carotid artery (CA) assessment before carotid endarterectomy (CEA).
  
  
  METHODS
  Twenty-five patients with symptomatic atherosclerotic stenosis in the carotid artery (involving 26 arteries) were scheduled for CEA. OB-CEMRI and digital subtraction angiography (DSA) were conducted within 1 week prior to CEA, and two radiologists independently assessed the location of maximal lumen stenosis, plaque rupture, degree of maximal lumen stenosis and plaque involvement on DSA and OB-CEMRI images. The differences of DSA and the OB-CEMRI in analyzing the plaque conditions were assessed in comparison with matched histological sections of the excised specimens.
  
  
  RESULTS
  Compared with the corresponding histological specimens, both DSA (κ=0.807) and OB-CEMRI (κ=0.812) showed a good consistency in defining the location of the maximal lumen stenosis. OB-CEMRI showed a better performance in detecting plaque rupture with higher sensitivity (90.0%) and specificity (83.3%) than DSA (40.0% and 66.7%, respectively). No significant difference was found between DSA and the OB-CEMRI in evaluating the degree of maximal lumen stenosis [(77.33∓3.79)% vs (76.02∓3.95)%, P=0.648]. Compared with the histological examination, OB-CEMRI appeared to underestimate the stenosis. The plaque extent on OB-CEMRI was larger than that on DSA (18.96∓4.96 mm vs 14.80∓3.78 mm, P=0.004), and similar to that by histological examination (18.13∓4.57 mm, P=0.506).
  
  
  CONCLUSIONS
  OB-CEMRI allows noninvasive and objective detection of the location of the maximal lumen stenosis, plaque rupture, and plaque extent, though with a lower accuracy than DSA in the assessment of the maximal lumen stenosis. OB-CEMRI combined with DSA offers a more reliable means for preoperative evaluation of the carotid artery plaques for CEA.
authors.affiliation: Department of Radiology, General Hospital of PLA, Beijing 100853, China. wangqingjun77@163.com
authors.forename: Qing-jun
authors.initials: QJ
authors.lastname: WANG
authors.forename: Yong
authors.initials: Y
authors.lastname: WANG
authors.forename: Jian-ming
authors.initials: JM
authors.lastname: CAI
authors.forename: Ting-qiang
authors.initials: TQ
authors.lastname: ZHAO
authors.forename: Lin
authors.initials: L
authors.lastname: MA
authors.forename: You-quan
authors.initials: YQ
authors.lastname: CAI
authors.forename: Li-feng
authors.initials: LF
authors.lastname: CHEN
authors.forename: Zhan-bo
authors.initials: ZB
authors.lastname: WANG
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000473:pathology*; D016893:Carotid Stenosis; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged