Pathological Control Of Carotid Atherosclerotic Plaque By Magnetic Resonance SNAP Sequence

Objective: To explore the simultaneous non-contrast angiogrphy and intraplaque hemorrhage magnetic resonance protocol(SNAP)diagnostic value of detection multiple components in carotid atherosclerotic plaque.Methods: Sixty-four patients with stenosis of the carotid underwent 3.0T MRI including 3D-SNAP and conventional multicontrast protocol,with 22 of them having carotid endarterectomy histology validation,the detection of major plaque components including calcification(CA),intraplaque hemorrhage(IPH),ulceration(UL)and ruptured fibrous cap(RFC).The agreement between SNAP and muiticontrast protocol in identifying CA,IPH,UL,RFC was analyzed using Cohen's kappa analysis.Then use histological findings as reference standard to comparison of SNAP and conventional multicontrast protocol in identifying plaque compoents and evauate the diagnostic accuracy of SNAP protocol.Results: SNAP and multicontrast prtocol showed a high consistency in characterization of plaque compositions(CA,IPH,UL,RFC: k=0.76,0.66,0.67,0.61);According to the postoperative histological setions,SNAP protocols identification of CA,IPH,UL and RFC consistency respectively k=0.87,0.88,0.78,0.82,all above index higher than multicontrast prtocol reveal.Conclusion: Magnetic resonance SNAP protocol can accrately identify multiple components of plaque,and has advantages in plaque ulcer display.SNAP protocol is a reliable method for clinical non-invasive evaluation of carotid atherosclerotic plaques.