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KMID : 1103720160740030160
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Journal of the Korean Society of Radiology
2016 Volume.74 No. 3 p.160 ~ p.168
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Assessment of Carotid Diffusion-Weighted Imaging for Detection of Lipid-Rich Necrotic Core in Symptomatic Carotid Atheroma
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Lee Kang-Ji
Kwak Hyo-Sung
Chung Gyung-Ho
Hwang Seung-Bae
Song Ji-Soo
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Abstract
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Purpose
To evaluate the diagnostic usefulness of diffusion-weighted MR imaging (DWI) compared with contrast-enhanced MR imaging for the detection of the lipid-rich necrotic core (LRNC) of symptomatic carotid atherosclerotic plaques.
Materials and Methods
Twenty-five patients (median age: 66 years; range: 45?78 years) with moderate-to-severe symptomatic carotid stenosis confirmed with contrast-enhanced carotid MR angiography who underwent carotid plaque MR imaging were retrospectively reviewed. An echo-planner DWI with b0, b200, b400, b800, and b1000 was performed along with carotid plaque MR imaging. Plaque visualization on DWI was analyzed by 2 reviewers on consensus. The contrast-to-noise ratio between the lumen and plaque was analyzed between variable b-values.
Results
Carotid atherosclerotic plaques were identified on carotid DWI in 8 patients. Confirmed carotid atherosclerotic plaques were not identified on carotid DWI in 16 patients. The DWI-identified group had plaques with significantly greater maximal wall thickness and longitudinal length, as compared with the non-identified group. DWI with b200 had a higher contrast-to-noise ratio between the lumen and LRNC (p < 0.001). The mean apparent diffusion coefficient value from DWI with b200 for the LRNC was 0.51 ± 1.55 × 10-3 mm2/s.
Conclusion
There was less frequent identification of carotid atherosclerotic plaques with carotid DWI, as compared with contrast-enhanced MR imaging. This study suggested that carotid DWI cannot replace contrast-enhanced MR imaging for the detection of carotid plaques, including LRNC.
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KEYWORD
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Carotid Artery Disease, Carotid Stenosis, Plaque, Atherosclerotic, Magnetic Resonance Angiography, Diffusion Weighted MRI
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