Quantitative evaluation of high intensity signal on MIP images of carotid atherosclerotic plaques from routine TOF-MRA reveals elevated volumes of intraplaque hemorrhage and lipid rich necrotic core.
Quantitative evaluation of high intensity signal on MIP images of carotid atherosclerotic plaques from routine TOF-MRA reveals elevated volumes of intraplaque hemorrhage and lipid rich necrotic core.
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DOI：
10.1186/1532-429x-14-81
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发表时间：
2012-11-29
期刊：
影响因子：
--
通讯作者：
Yuan C
中科院分区：
文献类型：
--
作者：
Yamada K;Song Y;Hippe DS;Sun J;Dong L;Xu D;Ferguson MS;Chu B;Hatsukami TS;Chen M;Zhou C;Yuan C
颈动脉斑块内出血 (IPH) 和富含脂质的坏死核心 (LRNC) 与斑块生长加速、管腔狭窄、未来表面破坏和症状事件的发展有关。本研究的目的是评估 TOF-MRA 斑块中的高强度信号 (HIS) 与通过多重对比加权 CMR 测量的 IPH 或 LRNC 体积之间的定量关系。超声检查怀疑有颈动脉狭窄或颈动脉斑块的 76 名患者接受了多重对比颈动脉 CMR。 HIS 的存在和体积是根据 TOF-MRA MIP 图像测量的，而 IPH 和 LRNC 体积是根据多对比 CMR 分别测量的。对于检测 IPH，MIP 图像上的 HIS 总体特异性较高（100.0%，95% CI：93.0 – 100.0%），但敏感性相对较低（32%，95% CI：20.8 – 47.9%）。然而，敏感性与基础 IPH 体积 (p = 0.033) 和狭窄程度 (p = 0.022) 呈显着递增关系。存在 HIS 的患者的平均 IPH 体积比不存在 HIS 的患者大 2.7 倍（142.8±97.7mm3 对比 53.4±56.3mm3，p=0.014）。同样，存在 HIS 的患者的平均 LRNC 体积是其 3.4 倍（379.8±203.4mm3 vs. 111.3±122.7mm3，p=0.001）。 HIS 区域的体积与多对比 CMR 测量的 IPH 体积之间存在很强的相关性 (r = 0.96，p < 0.001)。 MIP 图像可以轻松地从三分钟的常规临床 TOF 序列重新格式化。 TOF-MRA MIP 图像上颈动脉斑块中的高强度信号与斑块内出血增加和富含脂质的坏死核心体积相关。该技术对于中度至重度狭窄的患者最为敏感。
Carotid intraplaque hemorrhage (IPH) and lipid rich necrotic core (LRNC) have been associated with accelerated plaque growth, luminal narrowing, future surface disruption and development of symptomatic events. The aim of this study was to evaluate the quantitative relationships between high intensity signals (HIS) in the plaque on TOF-MRA and IPH or LRNC volumes as measured by multicontrast weighted CMR. Seventy six patients with a suspected carotid artery stenosis or carotid plaque by ultrasonography underwent multicontrast carotid CMR. HIS presence and volume were measured from TOF-MRA MIP images while IPH and LRNC volumes were separately measured from multicontrast CMR. For detecting IPH, HIS on MIP images overall had high specificity (100.0%, 95% CI: 93.0 – 100.0%) but relatively low sensitivity (32%, 95% CI: 20.8 – 47.9%). However, the sensitivity had a significant increasing relationship with underlying IPH volume (p = 0.033) and degree of stenosis (p = 0.022). Mean IPH volume was 2.7 times larger in those with presence of HIS than in those without (142.8 ± 97.7 mm3 vs. 53.4 ± 56.3 mm3, p = 0.014). Similarly, mean LRNC volume was 3.4 times larger in those with HIS present (379.8 ± 203.4 mm3 vs. 111.3 ± 122.7 mm3, p = 0.001). There was a strong correlation between the volume of the HIS region and the IPH volume measured from multicontrast CMR (r = 0.96, p < 0.001). MIP images are easily reformatted from three minute, routine, clinical TOF sequences. High intensity signals in carotid plaque on TOF-MRA MIP images are associated with increased intraplaque hemorrhage and lipid-rich necrotic core volumes. The technique is most sensitive in patients with moderate to severe stenosis.