Diffusion measurement of intraplaque hemorrhage and intramural hematoma using diffusion weighted MRI at 3T in cervical artery
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To assess the difference between carotid haemorrhagic plaque and non-haemorrhagic plaque by using diffusion-weighted imaging (DWI) and to evaluate carotid intraplaque haemorrhage (IPH) and intramural hematoma (IMH) of cervical artery dissection with apparent diffusion coefficient (ADC) measurement.
Fifty-one symptomatic patients underwent 3.0-T carotid MR imaging, including conventional sequences, three-dimensional (3D) magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence, and DWI. Thirty-nine patients with carotid plaque and eight patients with IMH of cervical artery dissection were finally included. The groups of hemorrhagic plaque, non-hemorrhagic plaque and IMH were divided according to 3D MPRAGE sequence. ADC values of different groups were measured, and t tests were performed.
The mean ADC values of hemorrhagic plaques, non-hemorrhagic plaque and IMH were (1.284 ± 0.327) × 10-3mm2/s, (1.766 ± 0.477) × 10-3mm2/s, and (0.563 ± 0.119) × 10-3mm2/s, respectively. The mean ADC values of hemorrhagic and non-hemorrhagic regions in the hemorrhagic plaque group were (0.985 ± 0.376) × 10-3mm2/s and (1.480 ± 0.465) × 10-3mm2/s, respectively. The differences between the hemorrhagic plaque and non-hemorrhagic plaque, hemorrhagic region and non-hemorrhagic region in hemorrhagic plaque, and the hemorrhagic region in the hemorrhagic plaque and IMH of artery dissection were significant (P < 0.05).
DWI may be a useful complement to conventional MR imaging for identifying haemorrhage of carotid plaques and differentiate IMHs from IPH.
• ADC values of IPH are lower than the plaque without IPH.
• DWI might be a useful complement to identify IPH.
• IMH may be differentiated from IPH by using DWI.
KeywordsMRI Diffusion-weighted imaging Carotid intraplaque haemorrhage Cervical artery dissection Intramural hematoma ADC
Apparent diffusion coefficient
Lipid-rich necrotic core
Magnetic resonance angiography
Magnetic resonance imaging
Magnetization-prepared rapid acquisition gradient-echo
The scientific guarantor of this publication is Guangbin Wang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.
No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental, performed at one institution.
- 5.Sadat U, Teng Z, Young VE et al (2010) Association between biomechanical structural stresses of atherosclerotic carotid plaques and subsequent ischaemic cerebrovascular events–a longitudinal in vivo magnetic resonance imaging-based finite element study. Eur J Vasc Endovasc Surg 40:485–491CrossRefPubMedGoogle Scholar
- 21.Kim SE, Jeong EK, Shi XF, Morrell G, Treiman GS, Parker DL (2009) Diffusion-weighted imaging of human carotid artery using 2D single-shot interleaved multislice inner volume diffusion-weighted echo planar imaging (2D ss-IMIV-DWEPI) at 3T_ diffusion measurement in atherosclerotic plaque. J Magn Reson Imaging 30:1068–1077CrossRefPubMedPubMedCentralGoogle Scholar
- 35.Markus HS, Droste DW, Kaps M (2005) Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using Doppler embolic signal detection: the clopidogrel and aspirin for reduction of emboli in symptomatic carotid stenosis (CARESS) trial. Circulation 111:2233–2240CrossRefPubMedGoogle Scholar