Quantitative Evaluation of Carotid Plaque Composition by In Vivo MRI

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Abstract
Objective— This study evaluates the ability of MRI to quantify all major carotid atherosclerotic plaque components in vivo. Methods and Results— Thirty-one subjects scheduled for carotid endarterectomy were imaged with a 1.5T scanner using time-of-flight–, T1-, proton density–, and T2-weighted images. A total of 214 MR imaging locations were matched to corresponding histology sections. For MRI and histology, area measurements of the major plaque components such as lipid-rich/necrotic core (LR/NC), calcification, loose matrix, and dense (fibrous) tissue were recorded as percentages of the total wall area. Intraclass correlation coefficients (ICCs) were computed to determine intrareader and inter-reader reproducibility. MRI measurements of plaque composition were statistically equivalent to those of histology for the LR/NC (23.7 versus 20.3%; P=0.1), loose matrix (5.1 versus 6.3%; P=0.1), and dense (fibrous) tissue (66.3% versus 64%; P=0.4). Calcification differed significantly when measured as a percentage... In vivo MR images of carotid plaques from 31 subjects scheduled for carotid endarterectomy were matched with corresponding histology sections. MRI measurements of plaque composition as percentage of the vessel wall corresponded to those of histology. This study demonstrates the potential of multicontrast MRI in the quantitative characterization of the main components of human atherosclerotic plaque.