• Huiyu Qiao, Feiyu Li, Dongxiang Xu, Gaifen Liu, Chun Yuan, and Xihai Zhao.
• Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
• Magn Reson Imaging. 2018 Nov 1; 53: 71-76.

Background And PurposeThis study sought to investigate the feasibility of three-dimensional MPRAGE in identifying the lipid-rich necrotic core (LRNC) and calcification (CA) of carotid atherosclerotic plaques.Materials And MethodsTwelve patients (mean age 68.4 ± 11.8 years; 7 males) with carotid atherosclerotic plaques on ultrasound were included and underwent multicontrast magnetic resonance (MR) vessel wall imaging. The contrast enhanced T1W (CE-T1W) images were considered as reference for identifying LRNC. The signal intensity of LRNC, CA, sterno-cleidomastoid muscle and fibrous tissue (FT) was measured on CE-T1W, T1W, T2W, and MPRAGE images, respectively. The relative signal intensity (rSI) of LRNC and CA against muscle or FT was compared among four sequences. Area under the curve (AUC) of rSIs of LRNC, CA and FT against muscle on MPRAGE, T1W and T2W images in discriminating the LRNC or CA from FT and the other plaque component was calculated.ResultsOf 352 slices, 88 (25.0%) had LRNC, 31 (8.8%) had CA, 14 (4.0%) had both LRNC and CA, and 247 (70.2%) had no components. Among four imaging sequences, MPRAGE images showed the lowest rSI of LRNC (0.34 ± 0.18) and CA (0.20 ± 0.16) against muscle, followed by T1W (0.48 ± 0.18 and 0.33 ± 0.21), CE-T1W (0.58 ± 0.23 and 0.40 ± 0.21) and T2W (0.71 ± 0.47 and 0.43 ± 0.40) images. In addition, the MPRAGE images showed the lowest rSI of LRNC (0.57 ± 0.26) and CA (0.33 ± 0.23) against FT. MPRAGE showed greater AUC than T2W and T1W in discriminating the LRNC (0.827 vs. 0.703 vs. 0.635) and CA (0.917 vs. 0.838 vs. 0.825).ConclusionMPRAGE sequence might be a potential non-contrast enhanced imaging tool for identification of carotid LRNC and CA.Copyright © 2018 Elsevier Inc. All rights reserved.

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