Repository logo
 

An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery.


Change log

Authors

Peng, Wenjia 
Zhan, Qian 
Zhang, Xuefeng 
Liu, Qi 

Abstract

OBJECTIVE: Although certain morphological features depicted by high resolution, multi-contrast magnetic resonance imaging (hrMRI) have been shown to be different between culprit and non-culprit middle cerebral artery (MCA) atherosclerotic lesions, the incremental value of hrMRI to define culprit lesions over stenosis has not been assessed. METHODS: Patients suspected with MCA stenosis underwent hrMRI. Lumen and outer wall were segmented to calculate stenosis, plaque burden (PB), volume (PV), length (PL) and minimum luminal area (MLA). RESULTS: Data from 165 lesions (112 culprit and 53 non-culprit) in 139 individuals were included. Culprit lesions were larger and longer with a narrower lumen and increased PB compared with non-culprit lesions. More culprit lesions showed contrast enhancement. Both PB and MLA were better indicators than stenosis in differentiating lesion types (AUC were 0.649, 0.732 and 0.737 for stenosis, PB and MLA, respectively). Combinations of PB, MLA and stenosis could improve positive predictive value (PPV) and specificity significantly. An optimal combination of stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm(2) produced a PPV = 85.7 %, negative predictive value = 54.1 %, sensitivity = 69.6 %, specificity = 75.5 %, and accuracy = 71.5 %. CONCLUSIONS: hrMRI plaque imaging provides incremental information to luminal stenosis in identifying culprit lesions. KEY POINTS: • High resolution MRI provides incremental information in defining culprit MCA atherosclerotic lesions. • Both plaque burden and minimum luminal area are better indicators than stenosis. • An optimal combination includes stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm (2) .

Description

Keywords

Magnetic resonance imaging, Middle cerebral artery, Minimum luminal area, Plaque burden, Stenosis, Aged, Case-Control Studies, Cerebral Angiography, Cerebrovascular Disorders, Constriction, Pathologic, Diffusion Magnetic Resonance Imaging, Female, Humans, Image Processing, Computer-Assisted, Intracranial Arteriosclerosis, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Middle Aged, Middle Cerebral Artery, Plaque, Atherosclerotic, Predictive Value of Tests, Sensitivity and Specificity

Journal Title

Eur Radiol

Conference Name

Journal ISSN

0938-7994
1432-1084

Volume Title

Publisher

Springer Science and Business Media LLC
Sponsorship
British Heart Foundation (None)
This research is supported by Shanghai Shenkang Porject SHDC12013110, Shanghai, China; British Heart Foundation (BHF) PG/11/74/29100; and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK. Dr Peng is supported by China Scholarship Council (201306580006), Beijing, China.