Novel Fusion Imaging of Muscle, Plaque, Arteries, and Bone Using MR Imaging for Carotid Endarterectomy Patients

Indications for carotid endarterectomy (CEA) and reduction of complications require evaluation of the plaque properties and location of the distal end of the plaque. High cervical location can be predicted from the anatomy of the vertebral body and mandibular bones and the locations of the posterior belly of the digastric muscle and stylohyoid muscle. Magnetic resonance (MR) imaging without contrast medium is useful for preoperative evaluation of the plaque, arteries, and bone characterization. However, no method for simultaneous evaluation of the muscle, plaque, arteries, and bone using MR imaging has been established.

Five patients with moderate or higher carotid artery stenosis underwent CEA in our institute. Noncontrast MR imaging/MR angiography and computed tomography (CT) angiography were performed before surgery in all cases. The fusion images of the muscle, plaque, arteries, and bone (M-PAB image) acquired from MR imaging/MR angiography, CT angiography, and the intraoperative view were compared.

M-PAB image, CT angiography, and intraoperative view were acquired in all cases with no obvious differences.

M-PAB imaging using MR imaging without contrast medium is useful for preoperative evaluation of CEA. This method does not require contrast agents and avoids radiation exposure.