Abstract
Background: Carotid plaque imaging with MRI is becoming more commonplace, but practical challenges exist in performing plaque imaging with surface coils. Purpose: To compare the diagnostic performance of a carotid plaque MRI protocol using a standard neurovascular coil (Neurovascular Coil Protocol) to a higher-resolution carotid plaque MRI using carotid surface coils (Surface Coil Protocol) in characterizing carotid plaque. Study Type: Prospective study comparing two MR techniques in plaque characterization. Population: Thirty-eight consecutive carotid artery disease patients. Field Strength/Sequence: Patients underwent 3T MRI using 1) a Neurovascular Coil Protocol including the following sequences: 3D-FSE T1 pre/postcontrast and precontrast 3D IR-FSPGR, and 2) a Surface Coil Protocol using standard multicontrast MRI sequences. Assessment: Plaque characteristics analyzed by two independent neuroradiologists included intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC), and thin/ruptured fibrous cap (TRFC). Statistical Tests: Diagnostic performance of the Neurovascular Coil Protocol was compared to the Surface Coil Protocol reference standard using receiver-operating curves. Results: For IPH, sensitivity, specificity, and area under the curve (AUC) of the Neurovascular Coil Protocol were 91.1% (95% confidence interval [CI]=78.8-97.5%), 87.0% (95% CI=66.4-97.2%), and 0.92, respectively. For LRNC without IPH sensitivity, specificity, and AUC were 73.3% (95% CI=44.9-92.2%), 85.7% (95% CI=67.3-96.0%), and 0.84, respectively. For TRFC, sensitivity, specificity, and AUC were 35.3% (95% CI=14.2-61.7%), 97.6% (95% CI=87.4-99.9%), and 0.66 respectively. Interobserver agreement for IPH, LRNC, and TRFC using the Neurovascular Coil Protocol were k=0.87 (95% CI=0.75-0.99), k=0.54 (95% CI=0.29-0.80), and k=0.41 (95% CI=0.08-0.74), respectively. Data Conclusion: Our Neurovascular Coil Protocol has high sensitivity, specificity, and accuracy in identifying IPH and LRNC but is limited in assessment of TRFC.
| Original language | English (US) |
|---|---|
| Journal | Journal of Magnetic Resonance Imaging |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Carotid plaque
- MRI
- Vessel wall imaging
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Diagnostic accuracy of a clinical carotid plaque MR protocol using a neurovascular coil compared to a surface coil protocol. / Brinjikji, Waleed; Demarco, J. Kevin; Shih, Robert; Lanzino, Giuseppe; Rabinstein, Alejandro; Hilditch, Christopher A.; Nicholson, Patrick J.; Huston, John.
In: Journal of Magnetic Resonance Imaging, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnostic accuracy of a clinical carotid plaque MR protocol using a neurovascular coil compared to a surface coil protocol
AU - Brinjikji, Waleed
AU - Demarco, J. Kevin
AU - Shih, Robert
AU - Lanzino, Giuseppe
AU - Rabinstein, Alejandro
AU - Hilditch, Christopher A.
AU - Nicholson, Patrick J.
AU - Huston, John
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Carotid plaque imaging with MRI is becoming more commonplace, but practical challenges exist in performing plaque imaging with surface coils. Purpose: To compare the diagnostic performance of a carotid plaque MRI protocol using a standard neurovascular coil (Neurovascular Coil Protocol) to a higher-resolution carotid plaque MRI using carotid surface coils (Surface Coil Protocol) in characterizing carotid plaque. Study Type: Prospective study comparing two MR techniques in plaque characterization. Population: Thirty-eight consecutive carotid artery disease patients. Field Strength/Sequence: Patients underwent 3T MRI using 1) a Neurovascular Coil Protocol including the following sequences: 3D-FSE T1 pre/postcontrast and precontrast 3D IR-FSPGR, and 2) a Surface Coil Protocol using standard multicontrast MRI sequences. Assessment: Plaque characteristics analyzed by two independent neuroradiologists included intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC), and thin/ruptured fibrous cap (TRFC). Statistical Tests: Diagnostic performance of the Neurovascular Coil Protocol was compared to the Surface Coil Protocol reference standard using receiver-operating curves. Results: For IPH, sensitivity, specificity, and area under the curve (AUC) of the Neurovascular Coil Protocol were 91.1% (95% confidence interval [CI]=78.8-97.5%), 87.0% (95% CI=66.4-97.2%), and 0.92, respectively. For LRNC without IPH sensitivity, specificity, and AUC were 73.3% (95% CI=44.9-92.2%), 85.7% (95% CI=67.3-96.0%), and 0.84, respectively. For TRFC, sensitivity, specificity, and AUC were 35.3% (95% CI=14.2-61.7%), 97.6% (95% CI=87.4-99.9%), and 0.66 respectively. Interobserver agreement for IPH, LRNC, and TRFC using the Neurovascular Coil Protocol were k=0.87 (95% CI=0.75-0.99), k=0.54 (95% CI=0.29-0.80), and k=0.41 (95% CI=0.08-0.74), respectively. Data Conclusion: Our Neurovascular Coil Protocol has high sensitivity, specificity, and accuracy in identifying IPH and LRNC but is limited in assessment of TRFC.
AB - Background: Carotid plaque imaging with MRI is becoming more commonplace, but practical challenges exist in performing plaque imaging with surface coils. Purpose: To compare the diagnostic performance of a carotid plaque MRI protocol using a standard neurovascular coil (Neurovascular Coil Protocol) to a higher-resolution carotid plaque MRI using carotid surface coils (Surface Coil Protocol) in characterizing carotid plaque. Study Type: Prospective study comparing two MR techniques in plaque characterization. Population: Thirty-eight consecutive carotid artery disease patients. Field Strength/Sequence: Patients underwent 3T MRI using 1) a Neurovascular Coil Protocol including the following sequences: 3D-FSE T1 pre/postcontrast and precontrast 3D IR-FSPGR, and 2) a Surface Coil Protocol using standard multicontrast MRI sequences. Assessment: Plaque characteristics analyzed by two independent neuroradiologists included intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC), and thin/ruptured fibrous cap (TRFC). Statistical Tests: Diagnostic performance of the Neurovascular Coil Protocol was compared to the Surface Coil Protocol reference standard using receiver-operating curves. Results: For IPH, sensitivity, specificity, and area under the curve (AUC) of the Neurovascular Coil Protocol were 91.1% (95% confidence interval [CI]=78.8-97.5%), 87.0% (95% CI=66.4-97.2%), and 0.92, respectively. For LRNC without IPH sensitivity, specificity, and AUC were 73.3% (95% CI=44.9-92.2%), 85.7% (95% CI=67.3-96.0%), and 0.84, respectively. For TRFC, sensitivity, specificity, and AUC were 35.3% (95% CI=14.2-61.7%), 97.6% (95% CI=87.4-99.9%), and 0.66 respectively. Interobserver agreement for IPH, LRNC, and TRFC using the Neurovascular Coil Protocol were k=0.87 (95% CI=0.75-0.99), k=0.54 (95% CI=0.29-0.80), and k=0.41 (95% CI=0.08-0.74), respectively. Data Conclusion: Our Neurovascular Coil Protocol has high sensitivity, specificity, and accuracy in identifying IPH and LRNC but is limited in assessment of TRFC.
KW - Carotid plaque
KW - MRI
KW - Vessel wall imaging
UR - http://www.scopus.com/inward/record.url?scp=85042458155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042458155&partnerID=8YFLogxK
U2 - 10.1002/jmri.25984
DO - 10.1002/jmri.25984
M3 - Article
C2 - 29479763
AN - SCOPUS:85042458155
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
SN - 1053-1807
ER -