Characterisation of carotid atherosclerotic plaque: comparison between magnetic resonance imaging and histology

Abstract

MRI is able to identify signs of carotid plaque instability with a high sensitivity and specificity. Therefore, it may be useful in evaluating and guiding the treatment of haemodynamically nonsignificant stenoses with a potential embolic risk and, in the future, to assess coronary plaque.

Window Settings for the Study of Calcified Carotid Plaques with Multidetector CT Angiography

“…[42][43][44] Calcification, in fact, was not discernible from the lumen on black-blood images but is distinguishable from the bright lumen on time-of-flight angiograms. Puppini et al 45 demonstrated that MR imaging sensitivity in the detection of calcifications is 80%. As reported by Kopps et al 46 during the study of calcified plaques of the aorta and of femoral arteries, MR imaging sometimes showed signal intensity loss typical of the presence of calcifications, though after histologic examination, no calcified plaques were found (false-positive presence).…”

MR and Targeted Molecular MRI of Vulnerable Plaques

“…The sensitivity and specificity in identifying a thin or ruptured FC was 81 and 90%, respectively [25]. The lipid core was identified with a mean sensitivity of 94% and a specificity of 79% [1,27,29], whereas calcifications were identified with a mean sensitivity of 77% and a specificity of 88% [27,28]. The sensitivity and specificity in identifying the intraplaque hemorrhage was 88 and 80%, respectively [27,28,29].…”

“…The lipid core was identified with a mean sensitivity of 94% and a specificity of 79% [1,27,29], whereas calcifications were identified with a mean sensitivity of 77% and a specificity of 88% [27,28]. The sensitivity and specificity in identifying the intraplaque hemorrhage was 88 and 80%, respectively [27,28,29]. In addition, using multiple contrast weightings (T1- and T2-weighted images) improves the detection of soft plaque components with a mean sensitivity of 96% and a specificity of 93% [30].…”

“…Morphologic measurements of the carotid vessel wall with MRI correlate closely with histology [26,29]. The visualization of FC status with MRI has also shown good agreement with histology [17], and unstable FCs (ulcerated, fissured, disrupted or cap thickness <0.25 mm) were detected with a high sensitivity of 81% and specificity of 90% [25].…”

Negative Carotid Artery Remodeling in Early Type 2 Diabetes Mellitus and Increased Carotid Plaque Vulnerability in Obesity as Assessed by Magnetic Resonance Imaging

“…Carotid magnetic resonance imaging (MRI) enables detailed noninvasive high‐resolution images of the carotid arterial wall and allows accurate characterization of the plaque composition. Carotid MRI plaque assessment has been validated by comparison with histological assessment of carotid endarterectomy samples 12, 13, 14, 15, 16, 17, 18. In patients with carotid atherosclerotic disease, the presence of carotid intraplaque hemorrhage, a lipid‐rich necrotic core, and thinned or ruptured fibrous cap detected by MRI is associated with increased risk of future stroke or transient ischemic attack 19.…”