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Atherosclerotic Plaques: Classification and Characterization with T2-weighted High-Spatial-Resolution MR Imaging—An in Vitro Study¹

¹ From the Laboratoire de Résonance Magnétique Nuclèaire Unité Mixte de Recherche, Villeurbanne, France (J.M.S., L.C., A.B.); Department of Radiology (J.M.S., P.C.D., J.M.C.) and Centre de Recherche et d’Applications en Traitement d l’Image et du Signal (J.M.S., P.C.D.), Hôpital Cardiovasculaire et Pneumologique L. Pradel, Bron, France; Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Md (J.M.S.); and Department of Vascular Surgery, Hôpital Edouart Herriot, Lyon, France (A.T.). From the 1999 RSNA scientific assembly. Received December 6, 1999; revision requested January 18, 2000; final revision received August 15; accepted September 12. Supported by a grant from La Fondation pour la Recherche Médicale, Paris, France. Address correspondence to J.M.S., Department of Diagnostic and Therapeutic Imaging, Hôpital Cardio-Vasculaire, B.P. Lyon Montchat, 69394 Lyon Cedex 03, France (e-mail: jserfaty@mri.jhu.edu).

PURPOSE: To evaluate if T2-weighted high-spatial-resolution magnetic resonance (MR) imaging (117 µm per pixel) can help accurate classification of atherosclerotic plaques.

MATERIALS AND METHODS: Thirty human arteries and 11 carotid endarterectomy specimens from 31 patients underwent T2-weighted MR imaging (2-T magnet; repetition time, 2,000 msec; echo time, 50 msec) at room temperature. After imaging, Bouin fixative was used to fix 26 arteries, and the other 15 arteries were fixed by means of freezing. Specimens were stained with hematoxylin-eosin and safranin or Sudan lipid stain. MR images and histologic slices were classified independently by two radiologists and a pathologist, respectively, on the basis of the American Heart Association classification.

RESULTS: Results with MR imaging were the following: type I–II plaques, sensitivity of 67% and specificity of 100%; type IV–Va plaques, sensitivity of 74% and specificity of 85%; type Vb plaques, sensitivity of 90% and specificity of 100%; type Vc plaques, sensitivity of 80% and specificity of 90%. No type III plaque was diagnosed in the study. The overall value was 0.68.

CONCLUSION: High-spatial-resolution MR imaging with T2 weighting alone can help accurate classification of fibrocalcic plaques (type Vb), but it is subject to limitations for the classification and analysis of other types of atherosclerotic plaques.

Index terms: Arteriosclerosis, 56.754, 9_*.721² • Magnetic resonance (MR), high-resolution, 56.121411, 9_*.721 • Magnetic resonance (MR), tissue characterization, 56.121411, 9_*.12916 • Magnetic resonance (MR), vascular studies, 9_*.12916

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