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Diagnostic accuracy of a clinical carotid plaque MR protocol using a neurovascular coil compared to a surface coil

Waleed Brinjikji1,2, J Kevin DeMarco3, Robert Shih3

  • 1Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Journal of Magnetic Resonance Imaging : JMRI
|February 27, 2018
PubMed
Abstract

Insights

The Neurovascular Coil Protocol demonstrates high accuracy for detecting intraplaque hemorrhage (IPH) and lipid-rich necrotic core (LRNC) in carotid plaques. However, its effectiveness is limited in assessing thin or ruptured fibrous caps (TRFC).

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Neuroimaging

Background:

  • Carotid plaque imaging using MRI is increasingly common.
  • Challenges exist in performing plaque imaging with surface coils.

Purpose of the Study:

  • To compare the diagnostic performance of a standard neurovascular coil protocol versus a higher-resolution surface coil protocol for carotid plaque characterization.
  • To evaluate the ability of each MRI protocol in identifying key plaque components.

Main Methods:

  • A prospective study compared two MRI protocols in 38 patients with carotid artery disease.
  • Protocols included a standard neurovascular coil and carotid surface coils at 3T MRI.
  • Plaque characteristics analyzed were intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC), and thin/ruptured fibrous cap (TRFC).

Main Results:

  • The Neurovascular Coil Protocol showed high sensitivity and specificity for IPH (AUC=0.92) and LRNC (AUC=0.84).
  • Performance for thin/ruptured fibrous cap (TRFC) was limited (AUC=0.66).
  • Interobserver agreement was substantial for IPH (k=0.87) and moderate for LRNC (k=0.54) and TRFC (k=0.41).

Conclusions:

  • The Neurovascular Coil Protocol is effective for identifying IPH and LRNC in carotid plaques.
  • Assessment of TRFC using the Neurovascular Coil Protocol requires further improvement.
  • This protocol offers a viable alternative for carotid plaque characterization, particularly for IPH and LRNC detection.
Keywords:
MRIcarotid plaquevessel wall imaging

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