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Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of Intraplaque Hemorrhage

Overview

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2010 May 15

PMID 20466799

Citations 3

Authors

Authors

R Bitar

A R Moody

S Symons

G Leung

S Crisp

A Kiss

A Nelson

R Maggisano

Affiliations

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Calcium can potentially shorten T1, generating high signal intensity in GREs. Because IPH appears as high signal intensity in MRIPH and the surface effects of calcium can potentially shorten T1 of surrounding water protons, the purpose of this study was to evaluate whether the high signal intensity seen on MRIPH could be attributed solely to IPH and not calcification.

Materials And Methods: Eleven patients undergoing carotid endarterectomy were imaged by using MRIPH. Calcification was assessed by scanning respective endarterectomy specimens with a tabletop MicroCT. MRIPH/MicroCT correlation used an 8-segment template. Two readers evaluated images from both modalities. Agreement between MRIPH/MicroCT was measured by calculating Cohen κ.

Results: High signal intensity was seen in 58.8% and 68.9% (readers 1 and 2, respectively) of MRIPH segments, whereas calcification was seen in 44.7% and 32.1% (readers 1 and 2, respectively) of MicroCT segments. High signal intensity seen by MRIPH showed very good but inverse agreement to calcification (κ = -0.90; P < .0001, 95% CI, -0.93 to -0.86, reader 1; and κ = -0.74; P < .0001; 95% CI, -0.81 to -0.69, reader 2). Most interesting, high signal intensity demonstrated excellent agreement with lack of calcification on MicroCT (κ = 0.92; P < .0001; 95% CI, 0.89-0.94, reader 1; and κ = 0.97; P < .0001; 95% CI, 0.96-0.99, reader 2). In a very small number of segments, high signal intensity was seen in MRIPH, and calcification was seen on MicroCT; however, these represented a very small proportion of segments with high signal intensity (5.9% and 1.6%, readers 1 and 2, respectively).

Conclusions: High signal intensity, therefore, reliably identified IPH, known to describe complicated plaque, rather than calcification, which is increasingly recognized as identifying more stable vascular disease.

Citing Articles

Characterization of Carotid Plaque Components by Quantitative Susceptibility Mapping.

Azuma M, Maekawa K, Yamashita A, Yokogami K, Enzaki M, Khant Z AJNR Am J Neuroradiol. 2019; 41(2):310-317.

PMID: 31879331 PMC: 7015197. DOI: 10.3174/ajnr.A6374.

Imaging Atherosclerotic Plaque Calcification: Translating Biology.

Bailey G, Meadows J, Morrison A Curr Atheroscler Rep. 2016; 18(8):51.

PMID: 27339750 PMC: 5206894. DOI: 10.1007/s11883-016-0601-6.

Advanced MRI for carotid plaque imaging.

Singh N, Moody A, Roifman I, Bluemke D, Zavodni A Int J Cardiovasc Imaging. 2015; 32(1):83-9.

PMID: 26293362 PMC: 4706840. DOI: 10.1007/s10554-015-0743-6.

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