Multi-sequence in vivo MRI can quantify fibrous cap and lipid core components in human carotid atherosclerotic plaques
Multi-sequence in vivo MRI can quantify fibrous cap and lipid core components in human carotid atherosclerotic plaques
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DOI：
10.1016/s1078-5884(04)00219-9
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发表时间：
2004-08-01
影响因子：
5.7
通讯作者：
Gillard, JH
中科院分区：
文献类型：
--
作者：
Trivedi, RA;U-King-Im, J;Gillard, JH
目标.血栓栓塞性中风的风险被认为是更好地反映了颈动脉斑块组成比管腔狭窄。我们着手确定高分辨率MRI是否是体内定量斑块成分的有效方法。一项前瞻性队列研究验证了活体MRI对切除颈动脉斑块的组织学分析。25例近期有症状的严重颈内动脉狭窄患者使用1.5 T系统进行颈动脉术前体内多序列MRI。根据净信号强度，在轴位MR图像上对单个斑块成分进行表征。纤维帽和脂质核心含量的分析与总斑块面积成比例定量。生成Bland-Altman图，计算类内系数以确定两种方法之间的一致性水平和观察者间的变异性。两个MR读者之间的类内相关系数分别为0.94和0.88量化纤维帽和脂质核心成分。纤维帽和脂质核心含量的MR和组织学定量之间具有良好的一致性;纤维帽的平均差异%为0.75%（+/-2.86%），脂质核心的平均差异%为0.86%（+/-1.76%）。高分辨率颈动脉MRI可用于量化斑块成分，并可证明在危险分层中有用。
Objectives. Risk of thrombo-embolic stroke is thought to be better reflected by carotid plaque composition than by luminal stenosis. We set out to determine whether high resolution MRI was a valid method of quantifying plaque components in vivo.Design. A prospective cohort study validating in vivo MRI against histological analysis of excised carotid plaques.Materials. Twenty-five recently symptomatic patients with severe internal carotid artery stenosis underwent pre-operative in vivo multi-sequence MRI of the carotid artery using a 1.5 T system.Methods. Individual plaque constituents were characterized on axial MR images according to net signal intensities. Analysis of fibrous cap and lipid core content was quantified proportional to overall plaque area. Bland-Altman plots were generated, and intra-class coefficients computed to determine the level of agreement between the two methods and interobserver variability.Results. The intra-class correlation coefficients between two MR readers were 0.94 and 0.88 for quantifying fibrous cap and lipid core components, respectively. There was good agreement between MR and histology derived quantification of both fibrous cap and lipid core content; the mean % difference for fibrous cap was 0.75% ( +/- 2.86%) and for lipid core was 0.86% (+/-1.76%).Conclusion. High resolution carotid MRI can be used to quantify plaque components and may prove useful in risk stratification.