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J Magn Reson Imaging. 2018 Mar;47(3):634-639. doi: 10.1002/jmri.25815. Epub 2017 Aug 2.

Evaluation of carotid atherosclerotic plaque surface characteristics utilizing simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) technique.

Author information

1
Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, P.R. China.
2
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
3
Healthcare Department, Philips Research China, Shanghai, P.R. China.
4
Department of Radiology, University of Washington, Seattle, Washington, USA.

Abstract

PURPOSE:

To evaluate the feasibility of the Simultaneous Noncontrast Angiography and intraPlaque hemorrhage (SNAP) technique in identification of carotid plaque surface characteristics compared with the conventional multicontrast vessel wall imaging protocol.

MATERIALS AND METHODS:

Thirty symptomatic patients with carotid plaque were recruited and underwent carotid artery magnetic resonance imaging (MRI) (3.0T) using a conventional multicontrast protocol and SNAP sequence. As an intrinsic multicontrast sequence, SNAP could generate a gray blood reference (Ref) image set, a black blood corrected real (CR) image set, and a bright blood MR angiography (MRA) image set. A bright blood SNAP Ref2 image was implemented by combining Ref and MRA images for facilitating plaque surface characteristics evaluation. The presence/absence of calcification (CA), juxtaluminal calcification (JCA), and ulceration was assessed. The agreement between SNAP and multicontrast vessel wall protocol in identifying CA, JCA, and ulceration was analyzed using Cohen's kappa analysis. The interreader and intrareader reproducibility of SNAP imaging in identifying plaque surface characteristics was also assessed.

RESULTS:

Good to excellent agreement was found between SNAP and conventional multicontrast protocol in identifying CA (κ = 0.74, 95% confidence interval [CI]: 0.54-0.93), JCA (κ = 0.81, 95% CI: 0.66-0.97), and ulceration (κ = 0.82, 95% CI: 0.65-0.99). In addition, excellent intrareader and interreader reproducibility was found for SNAP imaging in identification of CA, JCA, and ulceration.

CONCLUSION:

SNAP imaging showed excellent agreement with multicontrast imaging and high reproducibility in identification of both JCA and ulceration, suggesting that SNAP imaging may be a time-efficient, alternative tool in identification of plaque surface characteristics in carotid arteries.

LEVEL OF EVIDENCE:

4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:634-639.

KEYWORDS:

SNAP; juxtaluminal calcification; magnetic resonance imaging; surface characteristics; ulceration

PMID:
28766810
PMCID:
PMC5796877
DOI:
10.1002/jmri.25815
[Indexed for MEDLINE]
Free PMC Article

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