Evaluation of inflammatory status of atherosclerotic carotid plaque before thromboendarterectomy using delayed contrast-enhanced subtracted images after magnetic resonance angiography

Giacomo D E Papini, Giovanni Di Leo, Stefania Tritella, Giovanni Nano, Biagio Cotticelli, Claudio Clemente, Domenico G. Tealdi, Francesco Sardanelli

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To investigate the correlation among carotid plaque contrast enhancement (CPCE) at MRI, inflammatory cell infiltration (ICI) at histopathology, and carotid stenosis degree. Materials and methods: Twenty-eight patients (19 males; mean age 67 ± 9 years) scheduled for thromboendarterectomy prospectively underwent 1.5-T MR imaging using: (a) axial T1-weighted gradient-echo (T1wGRE) sequence centered on carotid bifurcations; (b) contrast-enhanced MR angiography (CE-MRA) with 0.1 mmol/kg of gadobenate dimeglumine; (c) enhanced axial T1wGRE sequence as in (a), 3 min after contrast injection. A three-point score system (absent, focal, wide) was used to assess CPCE on native and subtracted MRI images (c minus a) and ICI at histopathology. Carotid stenosis degree was determined on CE-MRA. Results: Six CPCE studies were discarded due to patient movement. In the remaining 22 studies, CPCE was absent, focal and wide in 13, 6 and 3 cases, respectively; ICI was absent, focal and wide in 13, 7 and 2 cases, respectively (k = 0.57). On CE-MRA 21/28 stenoses were severe and 7/28 moderate. There was no correlation either with ICI (p = 1.000, n = 28) or CPCE (p = 0.747, n = 22). Conclusion: The correlation between CPCE and ICI suggests a role for CPCE as an independent marker of plaque inflammation.

Original languageEnglish
JournalEuropean Journal of Radiology
Volume80
Issue number3
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Atherosclerosis
  • Carotid stenosis
  • Contrast material
  • Magnetic resonance angiography
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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