Carotid intraplaque hemorrhage imaging at 3.0-T MR imaging: Comparison of the diagnostic performance of three T1-weighted sequences

Hideki Ota, Vasily L. Yarnykh, Marina S. Ferguson, Hunter R. Underhill, J. Kevin Demarco, David C. Zhu, Minako Oikawa, Li Dong, Xihai Zhao, Alonso Collar, Thomas S. Hatsukami, Chun Yuan

Research output: Contribution to journalArticlepeer-review

156 Citations (Scopus)


Purpose: To compare the diagnostic performances of three T1-weighted 3.0-T magnetic resonance (MR) sequences at carotid intraplaque hemorrhage (IPH) imaging, with histologic analysis as the reference standard. Materials and Methods: Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Twenty patients scheduled for carotid endarterectomy underwent 3.0-T carotid MR imaging, including two-dimensional fast spin-echo, three-dimensional time-of-flight (TOF), and three-dimensional magnetization-prepared rapid acquisition gradient-echo (RAGE) sequences. Two reviewers blinded to the histologic findings assessed the presence, area, and signal intensity of IPH with each sequence. Detection statistics (sensitivity, specificity, and Cohen κ values) and agreement between area measurements (Pearson correlation coefficient [r] values) were calculated for each sequence. Results: When all 231 available MR sections were included for analysis, the magnetization-prepared RAGE (κ = 0.53) and fast spin-echo (κ = 0.42) sequences yielded moderate agreement between MR and histologic measurements, while the TOF sequence yielded fair agreement (κ = 0.33). However, when 47 sections with either small IPHs or heavily calcified IPHs were excluded, sensitivity, specificity, and κ values, respectively, were 80%, 97%, and 0.80 for magnetizationprepared RAGE imaging; 70%, 92%, and 0.63 for fast spinecho imaging; and 56%, 96%, and 0.57 for TOF imaging. MR imaging-histologic analysis correlation for IPH area was highest with magnetization-prepared RAGE imaging (r = 0.813), followed by TOF (r = 0.745) and fast spin-echo (r = 0.497) imaging. The capability of these three sequences for IPH detection appeared to be in good agreement with the quantitative contrast of IPH versus background plaque tissue. Conclusion: The magnetization-prepared RAGE sequence, as compared with the fast spin-echo and TOF sequences, demonstrated higher diagnostic capability for the detection and quantifi cation of IPH. Potential limitations of 3.0-T IPH MR imaging are related to hemorrhage size and coexisting calcification.

Original languageEnglish
Pages (from-to)551-563
Number of pages13
Issue number2
Publication statusPublished - 2010 Feb
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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