Carotid Plaque Characterization Using 3D T1-Weighted MR Imaging with Histopathologic Validation: A Comparison with 2D Technique
Carotid Plaque Characterization Using 3D T1-Weighted MR Imaging with Histopathologic Validation: A Comparison with 2D Technique
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DOI：
10.3174/ajnr.a4197
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发表时间：
2015-04-01
影响因子：
3.5
通讯作者：
Terayama, Y.
中科院分区：
文献类型：
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作者：
Narumi, S.;Sasaki, M.;Terayama, Y.
背景和目的：鉴于对比度和空间分辨率的潜在优势，3D FSE T1WI 最近已用于颈动脉斑块成像。然而，其诊断性能仍不清楚。因此，我们比较了该技术与传统图像轻松评估斑块特征的能力，并通过组织学分类验证了结果。 材料和方法：我们前瞻性地检查了 34 名颈动脉狭窄患者，使用 1.5T 扫描仪接受颈动脉内膜切除术，并获得 3D-FSE T1WI 和 2D 自旋回波 T1WI 扫描。在生成从 3D-FSE T1 加权图像获得的重新格式化图像后，我们计算了斑块和邻近肌肉的对比度，并将这些结果与病理分类进行比较。 结果：颈动脉斑块在组织学上分为 VII、VIII、IV-V 或 VI 型。对于 3D-FSE T1WI，每个分类的对比度范围如下：分别为 0.94-0.97（中位数，0.95）、0.95-1.29（中位数，1.10）、1.33-1.54（中位数，1.42）和 1.53-2.12（中位数，1.80）。对于 2D 成像，每个分类的对比度范围如下：分别为 0.79-1.02（中位数，0.90）、0.88-1.19（中位数，1.01）、1.17-1.46（中位数，1.23）和 1.55-2.51（中位数，2.07）。 4 组之间的结果存在显着差异 (P < .001)。 3D 技术区分易损斑块 (IV-VI) 和稳定斑块 (VII、VIII) 的敏感性和特异性均为 100%，2D 技术分别为 100% 和 91%。 结论：3D-FSE T1WI 准确表征颈动脉斑块内成分，与 2D-T1WI 相比具有出色的敏感性和特异性。
BACKGROUND AND PURPOSE: 3D FSE T1WI has recently been used for carotid plaque imaging, given the potential advantages in contrast and spatial resolutions. However, its diagnostic performance remains unclear. Hence, we compared the ability of this technique to readily assess plaque characteristics with that of conventional images and validated the results with histologic classification.MATERIALS AND METHODS: We prospectively examined 34 patients with carotid stenosis who underwent carotid endarterectomy by using 1.5T scanners and obtained 3D-FSE T1WI and 2D spin-echo T1WI scans. After generating reformatted images obtained from the 3D-FSE T1-weighted images, we calculated the contrast ratios for the plaques and the adjacent muscles and compared these findings with the pathologic classifications.RESULTS: Carotid plaques were histologically classified as types VII, VIII, IV-V, or VI. With 3D-FSE T1WI, the range of contrast ratios for each classification was the following: 0.94-0.97 (median, 0.95), 0.95-1.29 (median, 1.10), 1.33-1.54 (median, 1.42), and 1.53-2.12 (median, 1.80), respectively. With 2D imaging, the range of contrast ratios for each classification was the following: 0.79-1.02 (median, 0.90), 0.88-1.19 (median, 1.01), 1.17-1.46 (median, 1.23), and 1.55-2.51 (median, 2.07), respectively. Results were significantly different among the 4 groups (P < .001). Sensitivity and specificity for discriminating vulnerable plaques (IV-VI) from stable plaques (VII, VIII) were both 100% for the 3D technique and 100% and 91%, respectively, for the 2D technique.CONCLUSIONS: 3D-FSE T1WI accurately characterizes intraplaque components of the carotid artery, with excellent sensitivity and specificity compared with those of 2D-T1WI.