Quantification of calcifications in endarterectomy samples by means of high-resolution ultra-short echo time imaging

Magnetic resonance imaging (MRI) has proven its value for noninvasive assessment and classification of atherosclerotic lesions. MRI provides excellent access to soft tissue information, but its capability for assessing calcified segments of the lesion remains limited. The aim of this study was to investigate the ultra-short echo time (UTE) sequence for accurate quantification of the plaque volumes and qualitative assessment of the calcium density.

Images of 35 endarterectomy samples were acquired by a high-resolution UTE sequence (TE = 50 micros) technique and compared with the conventional gradient echo (fast field echo) approach, volume computed tomography, and histology.

The UTE technique yielded accurate quantification of the volume of the calcification as well as enabled qualitative assessment of the calcium density according to the resulting relative signal intensity. In comparison, the fast field echo technique yielded an average overestimation of the lesion size by about 35% and the low signal intensity did not allow a clear delineation of the different calcium densities.

The presented data provide evidence that incorporation of the UTE technique in today's MRI protocols for plaque classification holds the potential to add the missing important information on calcium volume and density solely based on MRI data.