Carotid plaque high-resolution MRI at 3 T: evaluation of a new imaging score for symptomatic plaque assessment.

Abstract:

PURPOSE:To assess the sensitivity and specificity of intra-plaque hemorrhage (IPH), large lipid-rich necrotic core (LR-NC) and ulceration or cap rupture (UCR) for symptomatic carotid plaque characterization and to evaluate a new imaging score [Hemorrhage, Ulceration or cap rupture, Lipid-rich necrotic Core (HULC) score based on the sum of presence/absence of IPH, UCR and LR-NC; range 0-3] for assessment of recently symptomatic carotid plaques. MATERIAL AND METHODS:Twenty-seven recently symptomatic (<8 weeks) and 36 asymptomatic patients with a carotid plaque thicker than 2 mm were prospectively imaged on a 3-T magnetic resonance (MR) system using high-resolution, multi-contrast MR sequences. Prior to analysis, all images were reviewed to assess image quality of each sequence. Sensitivity and specificity of IPH, LR-NC, UCR and HULC scores were calculated. RESULTS:Fifty-one patients were analyzed (26 symptomatic carotids and 67 asymptomatic carotids) after exclusion of studies with poor image quality. Sensitivity and specificity for symptomatic carotid plaque was, respectively, 46.1% and 97% for IPH, 84.6% and 73.1% for UCR and 80.7% and 76.1% for LR-NC. A HULC score of 2 or more showed a sensitivity of 73% and a specificity of 92.5%. CONCLUSION:At 3 T, intra-plaque hemorrhage is the most specific criterion to characterize symptomatic carotid plaque. The HULC score offers the best compromise between sensitivity and specificity.

journal_name

Magn Reson Imaging

authors

Gury-Paquet L,Millon A,Salami F,Cernicanu A,Scoazec JY,Douek P,Boussel L

doi

10.1016/j.mri.2012.04.024

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1424-31

issue

10

eissn

0730-725X

issn

1873-5894

pii

S0730-725X(12)00210-X

journal_volume

30

pub_type

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