title: Carotid plaque characterization using 3D T1-weighted MR imaging with histopathologic validation: a comparison with 2D technique.
abstract: OBJECTIVE
  3D FSE T1WI has recently been used for carotid plaque imaging, given the potential advantages in contrast and spatial resolutions. However, its diagnostic performance remains unclear. Hence, we compared the ability of this technique to readily assess plaque characteristics with that of conventional images and validated the results with histologic classification.
  
  
  METHODS
  We prospectively examined 34 patients with carotid stenosis who underwent carotid endarterectomy by using 1.5T scanners and obtained 3D-FSE T1WI and 2D spin-echo T1WI scans. After generating reformatted images obtained from the 3D-FSE T1-weighted images, we calculated the contrast ratios for the plaques and the adjacent muscles and compared these findings with the pathologic classifications.
  
  
  RESULTS
  Carotid plaques were histologically classified as types VII, VIII, IV-V, or VI. With 3D-FSE T1WI, the range of contrast ratios for each classification was the following: 0.94-0.97 (median, 0.95), 0.95-1.29 (median, 1.10), 1.33-1.54 (median, 1.42), and 1.53-2.12 (median, 1.80), respectively. With 2D imaging, the range of contrast ratios for each classification was the following: 0.79-1.02 (median, 0.90), 0.88-1.19 (median, 1.01), 1.17-1.46 (median, 1.23), and 1.55-2.51 (median, 2.07), respectively. Results were significantly different among the 4 groups (P < .001). Sensitivity and specificity for discriminating vulnerable plaques (IV-VI) from stable plaques (VII, VIII) were both 100% for the 3D technique and 100% and 91%, respectively, for the 2D technique.
  
  
  CONCLUSIONS
  3D-FSE T1WI accurately characterizes intraplaque components of the carotid artery, with excellent sensitivity and specificity compared with those of 2D-T1WI.
authors.affiliation: From the Departments of Neurology and Gerontology (S.N., T.N., M.Y.O., Y.T.) snarumi@iwate-med.ac.jp.
authors.forename: S
authors.initials: S
authors.lastname: Narumi
authors.affiliation: Institute for Biomedical Sciences (M.S.), Iwate Medical University, Morioka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: From the Departments of Neurology and Gerontology (S.N., T.N., M.Y.O., Y.T.).
authors.forename: T
authors.initials: T
authors.lastname: Natori
authors.affiliation: From the Departments of Neurology and Gerontology (S.N., T.N., M.Y.O., Y.T.).
authors.forename: M
authors.initials: M
authors.lastname: Yamaguchi Oura
authors.affiliation: Neurosurgery (K.O., M.K., Y.S., Y.O.).
authors.forename: K
authors.initials: K
authors.lastname: Ogasawara
authors.affiliation: Neurosurgery (K.O., M.K., Y.S., Y.O.).
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Neurosurgery (K.O., M.K., Y.S., Y.O.).
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Neurosurgery (K.O., M.K., Y.S., Y.O.).
authors.forename: Y
authors.initials: Y
authors.lastname: Ogasawara
authors.affiliation: Anatomy (J.H.).
authors.forename: J
authors.initials: J
authors.lastname: Hitomi
authors.affiliation: From the Departments of Neurology and Gerontology (S.N., T.N., M.Y.O., Y.T.).
authors.forename: Y
authors.initials: Y
authors.lastname: Terayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000145:classification* / Q000473:pathology*; D012680:Sensitivity and Specificity