Study Of High-resolution MRI For Vulnerable Carotid Plaque

Purpose: To investigate the value of high-resolution magnetic resonance imaging(MRI)in judging carotid atherosclerotic plaque,to compare with superb micro-vascular imaging(SMI)and digital subtraction angiography(DSA).To discuss the optimal checking method for the detection of vulnerable atherosclerotic plaque of carotid artery and provide help for clinical.Methods: Collecting 38 patients with carotid atherosclerotic plaques discovered by routine ultrasound examination(76 carotid arteries,84 plaques,22 males and 16 females,aged from55 y to 80y),inspecting by high-resolution MRI.MRI images were analysed by using MRI carotid plaques analysis software Vascular Plaque Diagnostics(VP Diagnostics,Seattle,USA).At the same time,images were confirmed by two experienced radiologists by double blind method to record feature of plaques and degree of carotid artery stenosis.Among 38 patients,there were 22 patients(44 carotid arteries,52 plaques)undergone superb micro-vascular imaging within one week after the high-resolution MR examination and the feature of plaques was recorded by sonographer.Among 38 patients,there were 21 patients(42 carotid arteries)accepted digital subtraction angiography(DSA)to record degree of carotid artery stenosis and with or without ulcerous plaques.These results were compared with high-resolution MRI and routine ultrasound examination respectively.Results: 80 cases of plaques were discovered by high-resolution MRI within 84 cases of carotid plaques which were found by routine ultrasound examination,among which there were 40 cases of stable plaques including 24 cases in internal carotid artery and 16 cases in the common carotid artery and 40 cases of vulnerable plaques including 22 cases in internal carotid arteries and 18 cases in the common carotid artery.In addition,52 cases undergone superb micro-vascular imaging within 84 cases of carotid plaques,among which there were 18 cases of stable plaques and 34 cases of vulnerable plaques.21 cases of stable plaques and 29 cases of vulnerable plaques were determined by high-resolution MRI with 2 cases failed to find.For feature of carotid atherosclerotic plaques,homogeneity test results showed there was a high consistency between the high-resolution MRI and superb micro-vascular imaging(Kappa=0.788,P<0.05).And for determination of degree of 42 carotid arteries stenosis caused by carotid atherosclerosis plaque,there also was a high consistency between the high-resolution MRI and DSA(Kappa=0.888,P<0.05).What’s more,results from routine ultrasound examination were nearly in accordance with DSA(Kappa=0.785,P <0.05).Conclusion: The high-resolution MRI and SMI have a excellent consistency in evaluating carotid plaque.In evaluating the stenosis of carotid atherosclerotic plaques,the high-resolution MRI have a better consistency with DSA compared with ultrasonography.The high-resolution MRI is more suitable for the evaluation of plaque and the treatment strategy.