Published online before print November 4, 2004, doi: 10.1161/01.ATV.0000149867.61851.31
© 2005 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Quantitative Evaluation of Carotid Plaque Composition by In Vivo MRI
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.
Correspondence to Chun Yuan, Professor, Department of Radiology, 1959 NE Pacific St, Box 357115, Seattle, WA 98195. 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.
In vivo MR images of carotid plaques from 31 subjects scheduled for carotid endarterectomy were matched with corresponding histology sections. MRI measurements of plaque composition as percentage of the vessel wall corresponded to those of histology. This study demonstrates the potential of multicontrast MRI in the quantitative characterization of the main components of human atherosclerotic plaque.
Key Words: atherosclerosis • magnetic resonance imaging • carotid artery • plaque
This article has been cited by other articles:
 |
|
 |
|
  A. Maehara, G. S. Mintz, and N. J. Weissman Advances in Intravascular Imaging Circ Cardiovasc Interv, October 1, 2009; 2(5): 482 - 490. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ota, W. Yu, H. R. Underhill, M. Oikawa, L. Dong, X. Zhao, N. L. Polissar, B. Neradilek, T. Gao, Z. Zhang, et al. Hemorrhage and Large Lipid-Rich Necrotic Cores Are Independently Associated With Thin or Ruptured Fibrous Caps: An In vivo 3T MRI Study Arterioscler Thromb Vasc Biol, October 1, 2009; 29(10): 1696 - 1701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Tang, Z. Teng, G. Canton, C. Yang, M. Ferguson, X. Huang, J. Zheng, P. K. Woodard, and C. Yuan Sites of Rupture in Human Atherosclerotic Carotid Plaques Are Associated With High Structural Stresses: An In Vivo MRI-Based 3D Fluid-Structure Interaction Study Stroke, October 1, 2009; 40(10): 3258 - 3263. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Boussel, S. Arora, J. Rapp, B. Rutt, J. Huston, D. Parker, C. Yuan, H. Bassiouny, D. Saloner, and For the MAPP Investigators Atherosclerotic Plaque Progression in Carotid Arteries: Monitoring with High-Spatial-Resolution MR Imaging--Multicenter Trial Radiology, September 1, 2009; 252(3): 789 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Chu, M. S. Ferguson, H. Chen, D. S. Hippe, W. S. Kerwin, G. Canton, C. Yuan, and T. S. Hatsukami Cardiac Magnetic Resonance Features of the Disruption-Prone and the Disrupted Carotid Plaque J. Am. Coll. Cardiol. Img., July 1, 2009; 2(7): 883 - 896. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Duivenvoorden, E. de Groot, B.M. Elsen, J.S. Lameris, R.J. van der Geest, E.S. Stroes, J.J.P. Kastelein, and A.J. Nederveen In Vivo Quantification of Carotid Artery Wall Dimensions: 3.0-Tesla MRI Versus B-Mode Ultrasound Imaging Circ Cardiovasc Imaging, May 1, 2009; 2(3): 235 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J M U-King-Im, T Y Tang, A Patterson, M J Graves, S Howarth, Z-Y Li, R Trivedi, D Bowden, P J Kirkpatrick, M E Gaunt, et al. Characterisation of carotid atheroma in symptomatic and asymptomatic patients using high resolution MRI J. Neurol. Neurosurg. Psychiatry, August 1, 2008; 79(8): 905 - 912. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Underhill, V. L. Yarnykh, T. S. Hatsukami, J. Wang, N. Balu, C. E. Hayes, M. Oikawa, W. Yu, D. Xu, B. Chu, et al. Carotid Plaque Morphology and Composition: Initial Comparison between 1.5- and 3.0-T Magnetic Field Strengths Radiology, August 1, 2008; 248(2): 550 - 560. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Harloff, P Dudler, A Frydrychowicz, C Strecker, A L Stroh, A Geibel, C Weiller, A Hetzel, J Hennig, and M Markl Reliability of aortic MRI at 3 Tesla in patients with acute cryptogenic stroke J. Neurol. Neurosurg. Psychiatry, May 1, 2008; 79(5): 540 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Saam, H. R. Underhill, B. Chu, N. Takaya, J. Cai, N. L. Polissar, C. Yuan, and T. S. Hatsukami Prevalence of American Heart Association type VI carotid atherosclerotic lesions identified by magnetic resonance imaging for different levels of stenosis as measured by duplex ultrasound. J. Am. Coll. Cardiol., March 11, 2008; 51(10): 1014 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. Hellings, F. L. Moll, J.-P. P.M. de Vries, P. de Bruin, D. P.V. de Kleijn, and G. Pasterkamp Histological Characterization of Restenotic Carotid Plaques in Relation to Recurrence Interval and Clinical Presentation: A Cohort Study Stroke, March 1, 2008; 39(3): 1029 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Y Tang, S. P S Howarth, S. R Miller, M. J Graves, J.-M. U-King-Im, R. A Trivedi, Z. Y. Li, S. R Walsh, A. P Brown, P. J Kirkpatrick, et al. Comparison of the inflammatory burden of truly asymptomatic carotid atheroma with atherosclerotic plaques contralateral to symptomatic carotid stenosis: an ultra small superparamagnetic iron oxide enhanced magnetic resonance study J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1337 - 1343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Groen, F. J.H. Gijsen, A. van der Lugt, M. S. Ferguson, T. S. Hatsukami, A. F.W. van der Steen, C. Yuan, and J. J. Wentzel Plaque Rupture in the Carotid Artery Is Localized at the High Shear Stress Region: A Case Report Stroke, August 1, 2007; 38(8): 2379 - 2381. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Saam, T. S. Hatsukami, N. Takaya, B. Chu, H. Underhill, W. S. Kerwin, J. Cai, M. S. Ferguson, and C. Yuan The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment Radiology, July 1, 2007; 244(1): 64 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Touze, J.-F. Toussaint, J. Coste, E. Schmitt, F. Bonneville, P. Vandermarcq, J.-Y. Gauvrit, F. Douvrin, J.-F. Meder, J.-L. Mas, et al. Reproducibility of High-Resolution MRI for the Identification and the Quantification of Carotid Atherosclerotic Plaque Components: Consequences for Prognosis Studies and Therapeutic Trials Stroke, June 1, 2007; 38(6): 1812 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Henneman, J. D. Schuijf, E. E. van der Wall, and J. J. Bax Non-invasive anatomical and functional imaging for the detection of coronary artery disease Br. Med. Bull., January 5, 2007; (2007) ldl014v2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Crouse III Thematic review series: Patient-Oriented Research. Imaging atherosclerosis: state of the art J. Lipid Res., August 1, 2006; 47(8): 1677 - 1699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Saam, J. Cai, L. Ma, Y.-Q. Cai, M. S. Ferguson, N. L. Polissar, T. S. Hatsukami, and C. Yuan Comparison of Symptomatic and Asymptomatic Atherosclerotic Carotid Plaque Features with in Vivo MR Imaging. Radiology, August 1, 2006; 240(2): 464 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Takaya, C. Yuan, B. Chu, T. Saam, H. Underhill, J. Cai, N. Tran, N. L. Polissar, C. Isaac, M. S. Ferguson, et al. Association Between Carotid Plaque Characteristics and Subsequent Ischemic Cerebrovascular Events: A Prospective Assessment With MRI--Initial Results Stroke, March 1, 2006; 37(3): 818 - 823. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Willinek Looking Beyond the Lumen to Predict Cerebrovascular Events: "The Road Less Travelled By" Stroke, March 1, 2006; 37(3): 759 - 760. [Full Text] [PDF]
|
|
|
|
 |
|
 N.F. Fanning, T.D. Walters, A.J. Fox, and S.P. Symons Association between Calcification of the Cervical Carotid Artery Bifurcation and White Matter Ischemia. AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 378 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Nighoghossian, L. Derex, and P. Douek The Vulnerable Carotid Artery Plaque: Current Imaging Methods and New Perspectives Stroke, December 1, 2005; 36(12): 2764 - 2772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Cai, T. S. Hatsukami, M. S. Ferguson, W. S. Kerwin, T. Saam, B. Chu, N. Takaya, N. L. Polissar, and C. Yuan In Vivo Quantitative Measurement of Intact Fibrous Cap and Lipid-Rich Necrotic Core Size in Atherosclerotic Carotid Plaque: Comparison of High-Resolution, Contrast-Enhanced Magnetic Resonance Imaging and Histology Circulation, November 29, 2005; 112(22): 3437 - 3444. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Takaya, C. Yuan, B. Chu, T. Saam, N. L. Polissar, G. P. Jarvik, C. Isaac, J. McDonough, C. Natiello, R. Small, et al. Presence of Intraplaque Hemorrhage Stimulates Progression of Carotid Atherosclerotic Plaques: A High-Resolution Magnetic Resonance Imaging Study Circulation, May 31, 2005; 111(21): 2768 - 2775. [Abstract] [Full Text] [PDF]
|
|