Quantification of carotid plaque composition with a multi-contrast atherosclerosis characterization (MATCH) MRI...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Biomedical Engineering

Background:

• Carotid atherosclerotic plaques with lipid-rich necrotic cores (LRNC) and intraplaque hemorrhage (IPH) increase stroke risk.
• Multi-sequence MRI quantifies plaque composition but suffers from long scan times and misregistration.
• Multi-contrast atherosclerosis characterization (MATCH) is a novel technique designed to overcome these limitations.

Purpose of the Study:

• To compare plaque composition quantification between MATCH and conventional multi-sequence MRI.
• To evaluate the diagnostic performance of MATCH for identifying key plaque components.

Main Methods:

• 54 carotid arteries from 27 symptomatic patients were imaged using MATCH and multi-sequence MRI on a 3.0T scanner.
• Image quality, scan time, and interobserver agreement (ICC) were assessed.
• Sensitivity and specificity of MATCH for detecting plaque components were calculated against multi-sequence MRI as the reference standard.

Main Results:

• MATCH demonstrated significantly lower image quality (p<0.05) but a substantially shorter scan time (7 vs. 40 min).
• Good to excellent interobserver agreement (ICC ≥ 0.77) was found for most plaque components with MATCH, except for calcifications and fibrous tissue.
• MATCH showed high sensitivity and specificity for LRNC (≥81%, 85%) and IPH (≥89%, 91%), but lower performance for calcifications (≥71%, 32%).

Conclusions:

• MATCH effectively quantifies LRNC and IPH in carotid plaques, offering significant advantages in speed and co-registration.
• MATCH is not suitable for quantifying calcifications due to lower accuracy.
• MATCH represents a promising advancement for clinical carotid plaque assessment, despite a trade-off in image quality.