title: Evaluation of carotid plaque vulnerability in vivo: Correlation between dynamic contrast-enhanced MRI and MRI-modified AHA classification.
abstract: To noninvasively monitor carotid plaque vulnerability by exploring the relationship between pharmacokinetic parameters (PPs) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and plaque types based on MRI-modified American Heart Association (AHA) classification, as well as to assess the ability of PPs in discrimination between stable and vulnerable plaques suspected on MRI.
  
  
  
  Of 70 consecutive patients with carotid plaques who volunteered for 3.0T MRI (3D time-of-flight [TOF], T1-weighted, T2-weighted, 3D magnetization-prepared rapid acquisition gradient-echo [MP-RAGE] and DCE-MRI), 66 participants were available for analysis. After plaque classification according to MRI-modified AHA Lesion-Type (LT), PPs (Ktrans, kep, ve, and vp) of DCE-MRI were measured. The Extended Tofts model was used for calculation of PPs. For participants with multiple carotid plaques, the plaque with the worst MRI-modified AHA LT was chosen for analysis. Correlations between PPs and plaque types and the ability of these parameters to distinguish stable and vulnerable plaques suspected on MRI were assessed.
  
  
  
  Significant positive correlation between Ktransand LT III to VI was found (ρ = 0.532, P < 0.001), as was the correlation between kepand LT III to VI (ρ = 0.409, P < 0.001). Stable and vulnerable plaques suspected on MRI could potentially be distinguished by Ktrans(sensitivity 83%, specificity 100%) and kep(sensitivity 77%, specificity 91%).
  
  
  
  Ktransand kepfrom DCE-MRI can provide quantitative information to monitor plaque vulnerability in vivo and differentiate vulnerable plaques suspected on MRI from stable ones. These two parameters could be adopted as imaging biomarkers for plaque characterization and risk stratification.
  
  
  
  1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:870-876.
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Ge
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Zien
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Shiteng
authors.initials: S
authors.lastname: Suo
authors.affiliation: Neurological & Mental Health Division, George Institute for Global Health, University of Sydney, Sydney, Australia.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
authors.affiliation: Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Jieqing
authors.initials: J
authors.lastname: Wan
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: carotid artery; dynamic; inflammation; neovascularization; vulnerable plaque