Carotid plaque characterization using 3D T1-weighted MR imaging with histopathologic validation: a comparison with 2D...

Area of Science:

• Radiology
• Medical Imaging
• Cardiovascular Disease

Background:

• Three-dimensional fast spin-echo T1-weighted imaging (3D FSE T1WI) offers potential advantages for carotid plaque imaging due to improved contrast and spatial resolution.
• The diagnostic performance of 3D FSE T1WI for assessing carotid plaque characteristics requires further clarification.

Purpose of the Study:

• To compare the diagnostic performance of 3D FSE T1WI with conventional 2D spin-echo T1WI for assessing carotid plaque characteristics.
• To validate the imaging findings against histologic classifications of carotid plaques.

Main Methods:

• Prospective examination of 34 patients with carotid stenosis undergoing carotid endarterectomy using 1.5T scanners.
• Acquisition of both 3D FSE T1WI and 2D spin-echo T1WI scans.
• Calculation of contrast ratios between plaques and adjacent muscles, followed by comparison with pathologic classifications.

Main Results:

• Histologic classification of carotid plaques included types VII, VIII, IV-V, and VI.
• 3D FSE T1WI showed significantly different contrast ratios across plaque types (P < .001), with medians of 0.95, 1.10, 1.42, and 1.80, respectively.
• The 3D technique achieved 100% sensitivity and specificity in discriminating vulnerable plaques (IV-VI) from stable plaques (VII, VIII), outperforming the 2D technique (100% sensitivity, 91% specificity).

Conclusions:

• 3D FSE T1WI provides accurate characterization of intraplaque components in the carotid artery.
• The 3D technique exhibits excellent sensitivity and specificity for plaque assessment, surpassing conventional 2D T1WI.