, Volume 46, Issue 9, pp 738–743 | Cite as

MRI-derived measurements of fibrous-cap and lipid-core thickness: the potential for identifying vulnerable carotid plaques in vivo

  • Rikin A. Trivedi
  • Jean-Marie U-King-Im
  • Martin J. Graves
  • Jo Horsley
  • Martin Goddard
  • Peter J. Kirkpatrick
  • Jonathan H. GillardEmail author
Diagnostic Neuroradiology


Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive patients scheduled for carotid endarterectomy underwent pre-operative in vivo multi-sequence MR imaging of the carotid artery. Individual plaque constituents were characterised on MR images. Fibrous-cap and lipid-core thickness was measured on MRI and histology images. Bland-Altman plots were generated to determine the level of agreement between the two methods. Multi-sequence MRI identified 133 corresponding MR and histology slices. Plaque calcification or haemorrhage was seen in 47 of these slices. MR and histology derived fibrous cap–lipid-core thickness ratios showed strong agreement with a mean difference between MR and histology ratios of 0.02 (±0.04). The intra-class correlation coefficient between two readers for measurements was 0.87 (95% confidence interval, 0.73 and 0.93). Multi-sequence, high-resolution MR imaging accurately quantified the relative thickness of fibrous-cap and lipid-core components of carotid atheromatous plaques. This may prove to be a useful tool to characterise vulnerable plaques in vivo.


Carotid MRI Atheroma Vulnerable plaque Quantitative 



The study was funded in part by the Stroke Association (UK)


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Rikin A. Trivedi
    • 1
    • 3
  • Jean-Marie U-King-Im
    • 1
  • Martin J. Graves
    • 1
  • Jo Horsley
    • 2
  • Martin Goddard
    • 2
  • Peter J. Kirkpatrick
    • 3
  • Jonathan H. Gillard
    • 1
    • 4
    Email author
  1. 1.University Department of RadiologyAddenbrooke’s HospitalCambridgeUK
  2. 2.Department of HistopathologyPapworth HospitalPapworth EverardUK
  3. 3.Academic Department of NeurosurgeryAddenbrooke’s HospitalCambridgeUK
  4. 4.Addenbrooke’s HospitalCambridgeUK

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