[Morphologic carotid plaque characteristics in symptomatic and asymptomatic patients on MRI compared to...

The morphologic concept of unstable high-risk-plaques is gaining importance for the decision on invasive therapy of carotid stenoses. Plaque morphology was investigated with MRI in vitro and in vivo with regard to limited diagnostic means.

Carotid stenoses of 12 patients were scanned with 1.5-T MRI preoperatively in vivo, as was the bifurcation plaque after the operation. The scans were compared with the histologic sections ( n=5) and opened plaques ( n=7).

The MR morphology was identified corresponding to histologic sections. The hyperintense necrotic core and hypointense fibrous cap (T2) were well defined. Due to moving artefacts, in vivo MRIs were less accurate.

The histomorphology of carotid plaques with necrotic core and fibrous cap, basic for understanding the concept of unstable high-risk plaques, is presented on MRI in vitro and in vivo. Further clinical studies should follow.