Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;52(2):534-541.
doi: 10.1002/jmri.27064. Epub 2020 Feb 10.

Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease

Chaoyue Wang  1   2   3 , Yue Zhang  1 , Jingwen Du  1 , István N Huszár  2   3 , Saifeng Liu  4 , Yongsheng Chen  4   5 , Sagar Buch  6 , Fang Wu  1 , Yuehong Liu  1 , Mark Jenkinson  2   3 , Charlie Chia-Tsong Hsu  7 , Zhaoyang Fan  8 , E Mark Haacke  4   5 , Qi Yang  1   8
Affiliations

Quantitative Susceptibility Mapping for Characterization of Intraplaque Hemorrhage and Calcification in Carotid Atherosclerotic Disease

Chaoyue Wang et al. J Magn Reson Imaging. 2020 Aug.

Abstract

Background: Carotid artery intraplaque hemorrhage (IPH), an unstable component of atherosclerosis, is associated with an increased risk of stroke.

Purpose: To investigate quantitative susceptibility mapping (QSM) as a tool for the evaluation of IPH and calcification in vivo.

Study type: Prospective.

Population: Ten healthy volunteers and 15 patients.

Field strength/sequence: 3.0T Susceptibility-weighted imaging (SWI), magnetization-prepared rapid acquisition with gradient echo (MP-RAGE), T1 -weighted sampling perfection with application of optimized contrasts using different flip angle evolution (T1 -SPACE), T2 -weighted turbo spin-echo (T2 WI), and time-of-flight (TOF) sequences.

Assessment: The vessel wall area of the carotid artery was measured with QSM and compared with T1 -SPACE on healthy volunteers. Four radiologists, blinded to clinical history and patient identity, determined the presence and area of IPH on MP-RAGE and QSM, as well as the area of calcification on T1 -SPACE and QSM.

Statistical tests: Bland-Altman analysis, Pearson correlation coefficients, linear regression analyses were performed to evaluate the concordance of area measurements. Cohen's kappa (κ) was analyzed to determine the agreement between IPH detections. The paired t-test was used to compare the group differences.

Results: In 423 matched slices, 20.1% (85/423) and 19.6% (83/423) were detected to have IPH on MP-RAGE and QSM, respectively. IPH detection by QSM and MP-RAGE showed good agreement (κ = 0.822, P < 0.001) between the two methods. There was no significant difference in IPH area measurements between QSM and MP-RAGE (7.28 mm2 ± 6.41 vs. 7.16 mm2 ± 5.99, P = 0.575). There was no significant difference in calcification area measurement between QSM and T1 -SPACE (3.51 mm2 ± 1.78 vs. 3.41 mm2 ± 2.02, P = 0.783).

Data conclusion: QSM is a novel imaging tool for the identification of IPH in patients with carotid atherosclerosis and enables differentiation of IPH and calcification. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1 J. Magn. Reson. Imaging 2020;52:534-541.

Keywords: calcification; carotid atherosclerosis; intraplaque hemorrhage; quantitative susceptibility mapping.

PubMed Disclaimer

Comment in

References

REFERENCES

    1. Cohen SN, Hobson RW 2nd, Weiss DG, Chimowitz M. Death associated with asymptomatic carotid artery stenosis: Long-term clinical evaluation. VA Cooperative Study 167 Group. J Vasc Surg 1993;18:1002-1011.
    1. Gupta A, Baradaran H, Schweitzer AD, et al. Carotid plaque MRI and stroke risk: A systematic review and meta-analysis. Stroke 2013;44:3071-3077.
    1. O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14-22.
    1. Kwee RM, van Oostenbrugge RJ, Prins MH, et al. Symptomatic patients with mild and moderate carotid stenosis: Plaque features at MRI and association with cardiovascular risk factors and statin use. Stroke 2010;41:1389-1393.
    1. Brinjikji W, Huston J 3rd, Rabinstein AA, Kim GM, Lerman A, Lanzino G. Contemporary carotid imaging: From degree of stenosis to plaque vulnerability. J Neurosurg 2016;124:27-42.

Publication types

MeSH terms

LinkOut - more resources