Skip to main content

Advertisement

SpringerLink
Log in

Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

Several magnetic resonance (MR) imaging techniques are used to examine atherosclerotic plaque of carotid arteries; however, the best technique for visualizing intraplaque characteristics has yet to be determined. Here, we directly compared four kinds of T1-weighted (T1W) imaging techniques with pathological findings in patients with carotid stenosis.

Methods

A total of 31 patients who were candidates for carotid endarterectomy were prospectively examined using a 1.5-T MRI scanner, which produced four kinds of T1W images, including non-gated spin echo (SE), cardiac-gated black-blood (BB) fast-SE (FSE), magnetization-prepared rapid acquisition with gradient echo (MPRAGE), and source image of three-dimensional time-of-flight MR angiography (SI-MRA). The signal intensity of the carotid plaque was manually measured, and the contrast ratio (CR) against the adjacent muscle was calculated. CRs from the four imaging techniques were compared to each other and correlated with histopathological specimens.

Results

CRs of the carotid plaques mainly containing fibrous tissue, lipid/necrosis, and hemorrhage were significantly different with little overlaps (range: 0.92–1.15, 1.22–1.52, and 1.55–2.30, respectively) on non-gated SE. However, BB-FSE showed remarkable overlaps among the three groups (0.89–1.10, 1.07–1.23, and 1.01–1.42, respectively). MPRAGE could discriminate fibrous plaques from hemorrhagic plaques but not from lipid/necrosis-rich plaques: (0.77–1.07, 1.45–2.43, and 0.85–1.42, respectively). SI-MRA showed the same tendencies (1.01–1.39, 1.45–2.57, and 1.12–1.39, respectively).

Conclusion

Among T1W MR imaging techniques, non-gated SE images can more accurately characterize intraplaque components in patients who underwent CEA when compared with cardiac-gated BB-FSE, MPRAGE, and SI-MRA images.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF (2010) Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 363:11–23

    Article  PubMed  CAS  Google Scholar 

  2. Yamada K, Yoshimura S, Kawasaki M, Enomoto Y, Asano T, Hara A, Minatoguchi S, Iwama T (2011) Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging. Atherosclerosis 215:399–404

    Article  PubMed  CAS  Google Scholar 

  3. Takaya N, Yuan C, Chu B, Saam T, Underhill H, Cai J, Tran N, Polissar NL, Isaac C, Ferguson MS, Garden GA, Cramer SC, Maravilla KR, Hashimoto B, Hatsukami TS (2006) Association between carotid plaque characteristics and subsequent ischemic cerebrovascular events: a prospective assessment with MRI—initial results. Stroke 37:818–823

    Article  PubMed  Google Scholar 

  4. Yamada N, Higashi M, Otsubo R, Sakuma T, Oyama N, Tanaka R, Iihara K, Naritomi H, Minematsu K, Naito H (2007) Association between signal hyperintensity on T1-weighted MR imaging of carotid plaques and ipsilateral ischemic events. AJNR Am J Neuroradiol 28:287–292

    PubMed  CAS  Google Scholar 

  5. Hatsukami TS, Yuan C (2010) MRI in the early identification and classification of high-risk atherosclerotic carotid plaques. Imaging Med 2:63–75

    Article  PubMed  Google Scholar 

  6. Yoshida K, Narumi O, Chin M, Inoue K, Tabuchi T, Oda K, Nagayama M, Egawa N, Hojo M, Goto Y, Watanabe Y, Yamagata S (2008) Characterization of carotid atherosclerosis and detection of soft plaque with use of black-blood MR imaging. AJNR Am J Neuroradiol 29:868–874

    Article  PubMed  CAS  Google Scholar 

  7. Yoshimura S, Yamada K, Kawasaki M, Asano T, Kanematsu M, Takamatsu M, Hara A (2011) High-intensity signal on time-of-flight magnetic resonance angiography indicates carotid plaques at high risk for cerebral embolism during stenting. Stroke 42:3132–3137

    Article  PubMed  Google Scholar 

  8. Watanabe Y, Nagayama M, Suga T, Yoshida K, Yamagata S, Okumura A, Amoh Y, Nakashita S, Van Cauteren M, Dodo Y (2008) Characterization of atherosclerotic plaque of carotid arteries with histopathological correlation: vascular wall MR imaging vs. color Doppler ultrasonography (US). J Magn Reson Imaging 28:478–485

    Article  PubMed  Google Scholar 

  9. Moody AR, Murphy RE, Morgan PS, Martel AL, Delay GS, Allder S, MacSweeney ST, Tennant WG, Gladman J, Lowe J, Hunt BJ (2003) Characterization of complicated carotid plaque with magnetic resonance direct thrombus imaging in patients with cerebral ischemia. Circulation 107:3047–3052

    Article  PubMed  Google Scholar 

  10. Tamhane AA, Arfanakis K (2009) Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) and turboprop MRI. Magn Reson Med 62:174–182

    Article  PubMed  Google Scholar 

  11. Narumi S, Sasaki M, Ohba H, Ogasawara K, Hitomi J, Mori K, Ohura K, Ono A, Terayama Y (2010) Altered carotid plaque signal among different repetition times on T1-weighted magnetic resonance plaque imaging with self-navigated radial-scan technique. Neuroradiology 52:285–290

    Article  PubMed  Google Scholar 

  12. Yuan C, Mitsumori LM, Beach KW, Maravilla KR (2001) Carotid atherosclerotic plaque: noninvasive MR characterization and identification of vulnerable lesions. Radiology 221:285–299

    Article  PubMed  CAS  Google Scholar 

  13. Chu B, Kampschulte A, Ferguson MS, Kerwin WS, Yarnykh VL, O'Brien KD, Polissar NL, Hatsukami TS, Yuan C (2004) Hemorrhage in the atherosclerotic carotid plaque: a high-resolution MRI study. Stroke 35:1079–1084

    Article  PubMed  Google Scholar 

  14. Ota H, Yarnykh VL, Ferguson MS, Underhill HR, Demarco JK, Zhu DC, Oikawa M, Dong L, Zhao X, Collar A, Hatsukami TS, Yuan C (2010) Carotid intraplaque hemorrhage imaging at 3.0-T MR imaging: comparison of the diagnostic performance of three T1-weighted sequences. Radiology 254:551–563

    Article  PubMed  Google Scholar 

  15. Hishikawa T, Iihara K, Yamada N, Ishibashi-Ueda H, Miyamoto S (2010) Assessment of necrotic core with intraplaque hemorrhage in atherosclerotic carotid artery plaque by MR imaging with 3D gradient–echo sequence in patients with high-grade stenosis. Clinical article. J Neurosurg 113:890–896

    Article  PubMed  Google Scholar 

  16. Yamaguchi M, Sasaki M, Ohba H, Mori K, Narumi S, Katsura N, Ohura K, Kudo K, Terayama Y (2012) Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging. Neuroradiology [Epub ahead of print]

  17. Balu N, Chu B, Hatsukami TS, Yuan C, Yarnykh VL (2008) Comparison between 2D and 3D high-resolution black-blood techniques for carotid artery wall imaging in clinically significant atherosclerosis. J Magn Reson Imaging 27:918–924

    Article  PubMed  Google Scholar 

  18. Crowe LA, Gatehouse P, Yang GZ, Mohiaddin RH, Varghese A, Charrier C, Keegan J, Firmin DN (2003) Volume-selective 3D turbo spin echo imaging for vascular wall imaging and distensibility measurement. J Magn Reson Imaging 17:572–580

    Article  PubMed  Google Scholar 

  19. Cappendijk VC, Heeneman S, Kessels AG, Cleutjens KB, Schurink GW, Welten RJ, Mess WH, van Suylen RJ, Leiner T, Daemen MJ, van Engelshoven JM, Kooi ME (2008) Comparison of single-sequence T1w TFE MRI with multisequence MRI for the quantification of lipid-rich necrotic core in atherosclerotic plaque. J Magn Reson Imaging 27:1347–1355

    Article  PubMed  Google Scholar 

  20. Underhill HR, Yarnykh VL, Hatsukami TS, Wang J, Balu N, Hayes CE, Oikawa M, Yu W, Xu D, Chu B, Wyman BT, Polissar NL, Yuan C (2008) Carotid plaque morphology and composition: initial comparison between 1.5- and 3.0-T magnetic field strengths. Radiology 248:550–560

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported in part by a Research Grant for Cardiovascular Diseases (20C-1) from the Ministry of Heath, Labor and Welfare of Japan, a Grant-in-Aid for Strategic Medical Science Research Center, and Grants-in-Aid for Science Research (22890169, 22590963) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

Conflict of interest

MS consults for Hitachi Medical Corporation and has received honoraria for lectures from the same company.

Author information

Authors and Affiliations

  1. Department of Neurology and Gerontology, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Ayumi Saito, Shinsuke Narumi, Hideki Ohba, Mao Yamaguchi & Yasuo Terayama

  2. Institute for Biomedical Sciences, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Makoto Sasaki & Kohsuke Kudo

  3. Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Kuniaki Ogasawara & Masakazu Kobayashi

  4. Department of Anatomy, Iwate Medical University, 19-1 Uchimaru, Morioka, Japan

    Jiro Hitomi

Authors
  1. Ayumi Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Makoto Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kuniaki Ogasawara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masakazu Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jiro Hitomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinsuke Narumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hideki Ohba
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mao Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kohsuke Kudo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yasuo Terayama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Makoto Sasaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saito, A., Sasaki, M., Ogasawara, K. et al. Carotid plaque signal differences among four kinds of T1-weighted magnetic resonance imaging techniques: A histopathological correlation study. Neuroradiology 54, 1187–1194 (2012). https://doi.org/10.1007/s00234-012-1025-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-012-1025-9

Keywords

Search

Navigation