Carotid plaque high-resolution MRI at 3 T: evaluation of a new imaging score for symptomatic plaque assessment |
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Authors: | Laurence Gury-Paquet Antoine Millon Fatima Salami Alexandru Cernicanu Jean-Yves Scoazec Philippe Douek Loïc Boussel |
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Institution: | 1. Department of Radiology, Centre Hospitalier Lyon Sud, 69495 Pierre-Bénite, Lyon, France;2. Department of Radiology, Louis Pradel Hospital, CREATIS, UMR CNRS 5515, INSERM U630, Lyon, France;3. Philips Healthcare, Best, The Netherlands;4. Department of Anatomopathology, Edouard Herriot University Hospital, Lyon, France |
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Abstract: | PurposeTo 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 methodsTwenty-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.ResultsFifty-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%.ConclusionAt 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. |
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Keywords: | Magnetic resonance imaging Plaque Atherosclerosis Carotid stenosis |
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