Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:2756-2761
© 1999 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
The Diagnostic Accuracy of Ex Vivo MRI for Human Atherosclerotic Plaque Characterization
From The Cardiovascular Institute (M.S., J.T.F., Z.A.F., J.J.B., V.F.) and the Departments of Medicine (M.S., J.T.F., V.F.), Pathology (J.T.F.), Radiology (M.S., Z.A.F.) and Surgery (M.H., E.H.), The Mount Sinai School of Medicine (M.L., D.D.), New York, NY; and Children’s Hospital of Philadelphia (S.W.), Philadelphia, Penn.
Correspondence to Meir Shinnar, MD, PhD, Box 1030, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029. E-mail meir_shinnar{at}smtplink.mssm.edu
Abstract—Recent evidence indicates that the type of atherosclerotic plaque, rather than the degree of obstruction to flow, is an important determinant of the risk of cardiovascular complications. In previous work, the feasibility of using MRI for the characterization of plaque components was shown. This study extends the previous work to all the plaque components and shows the accuracy of this method. Twenty-two human carotid endarterectomy specimens underwent ex vivo MRI and histopathological examination. Sixty-six cross sections were matched between MRI and histopathology. In each cross section, the presence or absence of plaque components were prospectively identified on the MRI images. The overall sensitivity and specificity for each tissue component were very high. Calcification and fibrocellular tissue were readily identified. Lipid core was also identifiable. However, thrombus was the plaque component for which MRI had the lowest sensitivity. A semiautomated algorithm was created to identify all major atherosclerotic plaque components. MRI can characterize carotid artery plaques with a high level of sensitivity and specificity. Application of these results in the clinical setting may be feasible in the near future.
Key Words: MRI • atherosclerosis • carotid endarterectomy
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