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on November 4, 2004

Arteriosclerosis, Thrombosis, and Vascular Biology. 2004
Published online before print November 4, 2004, doi: 10.1161/01.ATV.0000149867.61851.31
A more recent version of this article appeared on January 1, 2005
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Medline Plus Health Information
*Carotid Artery Disease
*MRI Scans

Submitted on July 7, 2004
Accepted on October 26, 2004

Quantitative Evaluation of Carotid Plaque Composition by In Vivo MRI

T. Saam ; M. S. Ferguson ; V. L. Yarnykh ; N. Takaya ; D. Xu ; N. L. Polissar ; T. S. Hatsukami ; and C. Yuan *

From the Department of Radiology (T.S., M.S.F., V.L.Y., N.T., D.X., C.Y.), University of Washington; Mountain-Whisper-Light Statistical Consulting (N.L.P.); and the Department of Surgery, University of Washington, and VA Puget Sound Health Care System (T.S.H.), Seattle, Wash.

* To whom correspondence should be addressed. E-mail: cyuan{at}u.washington.edu.

Objective--This study evaluates the ability of MRI to quantify all major carotid atherosclerotic plaque components in vivo.

Methods and Results--Thirty-one subjects scheduled for carotid endarterectomy were imaged with a 1.5T scanner using time-of-flight-, T1-, proton density-, and T2-weighted images. A total of 214 MR imaging locations were matched to corresponding histology sections. For MRI and histology, area measurements of the major plaque components such as lipid-rich/necrotic core (LR/NC), calcification, loose matrix, and dense (fibrous) tissue were recorded as percentages of the total wall area. Intraclass correlation coefficients (ICCs) were computed to determine intrareader and inter-reader reproducibility. MRI measurements of plaque composition were statistically equivalent to those of histology for the LR/NC (23.7 versus 20.3%; P=0.1), loose matrix (5.1 versus 6.3%; P=0.1), and dense (fibrous) tissue (66.3% versus 64%; P=0.4). Calcification differed significantly when measured as a percentage of wall area (9.4 versus 5%; P<0.001). Intrareader and inter-reader reproducibility was good to excellent for all tissue components, with ICCs ranging from 0.73 to 0.95.

Conclusions--MRI-based tissue quantification is accurate and reproducible. This application can be used in therapeutic clinical trials and in prospective longitudinal studies to examine carotid atherosclerotic plaque progression and regression.




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