Won Yong Kim

3D Isotropic MR Culprit Plaque Visualization of Carotid Plaque Edema and Hemorrhage with Motion Sensitized Blood Suppression

Research output: Contribution to book/anthology/report/proceedingConference abstract in proceedingsResearchpeer-review

  • Esben Søvsø Szocska Hansen
  • Steen Fjord Pedersen
  • Lars Ø. Bloch, Institut for Klinisk Medicin, the MR Research Centre, Denmark
  • Anne Grøndahl, Institut for Klinisk Medicin - The MR Research Centre, Denmark
  • Nikolaj Eldrup, Denmark
  • Anette Klærke, Dept. of Cardiothoracic an Vascular Surgery T, Denmark
  • Won Yong Kim
Atherosclerotic carotid artery disease is estimated to represent the etiology for one quarter of all strokes.
Carotid cardiovascular magnetic resonance (CMR) and magnetic resonance angiography are promising tools
in the evaluation of carotid atherosclerosis. Intraplaque hemorrhage and plaque edema may represent
advanced stages of atherosclerosis[1, 2]. In this study, we present a novel multi-contrast 3D motion sensitized
black-blood CMR imaging sequence, which detects both plaque edema and hemorrhage with positive

Subjects and Methods
The 3D imaging sequence was evaluated in 6 patients scheduled for carotids endarterectomy (6 Males, mean
age 70+/-13y) without any contraindications for CMR. All subjects underwent a carotid CMR examination on a
1.5 T MR scanner (Intera, Philips Healthcare, Best, The Netherlands) using a Philips Flex-m dual channel
SENSE coil. The parameters for the 3D turbo field echo carotid vessel wall scan using cardiac triggering were:
matrix size = 200x200, isotropic resolution of 1.5x1.5x1.5mm3, 133 slices, TR/TE 5.9/(1.88/3.5), flip angle = 15,
fat suppression with multiecho 2-point DIXON, T2 preparation echo time 16ms with two refocusing pulses,
motion sensitized gradient set to 2.1ms and scan time 2:43min.

The 3D isotropic CMR method showed excellent nulling of the blood even at the carotid bifurcation without flow
artifacts in all subjects. Due to the 3D isotropic resolution and excellent suppression of signal from blood,
image formatting in all three dimensions was possible to provide a comprehensive and exhaustive evaluation
of the vessel wall. For the symptomatic carotid artery plaque, hyperintensive signal intensity was detected with
a signal-to-noise ratio (SNR) that was significantly higher compared to the vessel wall proximal to the
bifurcation (43.36±8.01 versus 16.91±3.49, respectively P < 0.001) (Figure 1). SNR for the vessel lumen was
3.61±1.43 indicating excellent blood suppression. Contrast-to-noise ratio (CNR) for the carotid plaque
compared to the proximal carotid vessel wall was 26.45±4.60 and CNR plaque to lumen was 39.74±6.75.

In conclusion, the proposed 3D isotropic multi-contrast CMR technique detects plaque edema and
hemorrhage with positive contrast and excellent black-blood contrast, which may facilitate evaluation of carotid
atherosclerosis. Ongoing studies will include CMR correlation with histology to confirm the presence of
advanced atherosclerosis.
Original languageEnglish
Title of host publicationESMRMB 2013 – 30th Annual Scientific Meeting
Publication year2014
Publication statusPublished - 2014
EventESMRMB 2013 – 30th Annual Scientific Meeting - Toulouse, France
Duration: 3 Oct 20135 Oct 2013
Conference number: 30


ConferenceESMRMB 2013 – 30th Annual Scientific Meeting

    Research areas

  • Imaging, Clinical Application, Vasculature, Angiography

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