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Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of Intraplaque Hemorrhage

Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of... This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2126v1 31/8/1403 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Bitar, R. Articles by Maggisano, R. PubMed PubMed Citation Articles by Bitar, R. Articles by Maggisano, R. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:1403-1407, September 2010 © 2010 American Society of Neuroradiology HEAD AND NECK Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of Intraplaque Hemorrhage R. Bitar a ,b , A.R. Moody a ,b , S. Symons a ,b , G. Leung b , S. Crisp b , A. Kiss c , A. Nelson b and R. Maggisano d a From the Department of Medical Imaging (R.B., A.R.M., S.S.), University of Toronto, Toronto, Ontario, Canada b Department of Medical Imaging (R.B., A.R.M., S.S., G.L., S.C., A.N.) c Institute for Clinical Evaluative Sciences (A.K.) d Division of Vascular Surgery (R.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Please address correspondence to Alan Moody, MD, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room AG 46, Toronto, ON, Canada M4N 3M5; e-mail: alan.moody@sunnybrook.ca BACKGROUND AND PURPOSE: Calcium can potentially shorten T1, generating high signal intensity in GREs. Because IPH appears as high signal intensity in MRIPH and the surface effects of calcium can potentially shorten T1 of surrounding water protons, the purpose of this study was to evaluate whether the high signal intensity seen on MRIPH could be attributed solely to IPH and not calcification. MATERIALS AND METHODS: Eleven patients undergoing carotid endarterectomy were imaged by using MRIPH. Calcification was assessed by scanning respective endarterectomy specimens with a tabletop MicroCT. MRIPH/MicroCT correlation used an 8-segment template. Two readers evaluated images from both modalities. Agreement between MRIPH/MicroCT was measured by calculating Cohen . RESULTS: High signal intensity was seen in 58.8% and 68.9% (readers 1 and 2, respectively) of MRIPH segments, whereas calcification was seen in 44.7% and 32.1% (readers 1 and 2, respectively) of MicroCT segments. High signal intensity seen by MRIPH showed very good but inverse agreement to calcification ( = –0.90; P < .0001, 95% CI, –0.93 to –0.86, reader 1; and = –0.74; P < .0001; 95% CI, –0.81 to –0.69, reader 2). Most interesting, high signal intensity demonstrated excellent agreement with lack of calcification on MicroCT ( = 0.92; P < .0001; 95% CI, 0.89–0.94, reader 1; and = 0.97; P < .0001; 95% CI, 0.96–0.99, reader 2). In a very small number of segments, high signal intensity was seen in MRIPH, and calcification was seen on MicroCT; however, these represented a very small proportion of segments with high signal intensity (5.9% and 1.6%, readers 1 and 2, respectively). CONCLUSIONS: High signal intensity, therefore, reliably identified IPH, known to describe complicated plaque, rather than calcification, which is increasingly recognized as identifying more stable vascular disease. Abbreviations: AHA, American Heart Association • CI, confidence interval • FSE, fast spin-echo • GRE, gradient-recalled echo • IPH, intraplaque hemorrhage • MRIPH, MR imaging of intraplaque hemorrhage Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of Intraplaque Hemorrhage

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References (36)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2126
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2126v1 31/8/1403 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Bitar, R. Articles by Maggisano, R. PubMed PubMed Citation Articles by Bitar, R. Articles by Maggisano, R. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:1403-1407, September 2010 © 2010 American Society of Neuroradiology HEAD AND NECK Carotid Atherosclerotic Calcification Does Not Result in High Signal Intensity in MR Imaging of Intraplaque Hemorrhage R. Bitar a ,b , A.R. Moody a ,b , S. Symons a ,b , G. Leung b , S. Crisp b , A. Kiss c , A. Nelson b and R. Maggisano d a From the Department of Medical Imaging (R.B., A.R.M., S.S.), University of Toronto, Toronto, Ontario, Canada b Department of Medical Imaging (R.B., A.R.M., S.S., G.L., S.C., A.N.) c Institute for Clinical Evaluative Sciences (A.K.) d Division of Vascular Surgery (R.M.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Please address correspondence to Alan Moody, MD, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room AG 46, Toronto, ON, Canada M4N 3M5; e-mail: alan.moody@sunnybrook.ca BACKGROUND AND PURPOSE: Calcium can potentially shorten T1, generating high signal intensity in GREs. Because IPH appears as high signal intensity in MRIPH and the surface effects of calcium can potentially shorten T1 of surrounding water protons, the purpose of this study was to evaluate whether the high signal intensity seen on MRIPH could be attributed solely to IPH and not calcification. MATERIALS AND METHODS: Eleven patients undergoing carotid endarterectomy were imaged by using MRIPH. Calcification was assessed by scanning respective endarterectomy specimens with a tabletop MicroCT. MRIPH/MicroCT correlation used an 8-segment template. Two readers evaluated images from both modalities. Agreement between MRIPH/MicroCT was measured by calculating Cohen . RESULTS: High signal intensity was seen in 58.8% and 68.9% (readers 1 and 2, respectively) of MRIPH segments, whereas calcification was seen in 44.7% and 32.1% (readers 1 and 2, respectively) of MicroCT segments. High signal intensity seen by MRIPH showed very good but inverse agreement to calcification ( = –0.90; P < .0001, 95% CI, –0.93 to –0.86, reader 1; and = –0.74; P < .0001; 95% CI, –0.81 to –0.69, reader 2). Most interesting, high signal intensity demonstrated excellent agreement with lack of calcification on MicroCT ( = 0.92; P < .0001; 95% CI, 0.89–0.94, reader 1; and = 0.97; P < .0001; 95% CI, 0.96–0.99, reader 2). In a very small number of segments, high signal intensity was seen in MRIPH, and calcification was seen on MicroCT; however, these represented a very small proportion of segments with high signal intensity (5.9% and 1.6%, readers 1 and 2, respectively). CONCLUSIONS: High signal intensity, therefore, reliably identified IPH, known to describe complicated plaque, rather than calcification, which is increasingly recognized as identifying more stable vascular disease. Abbreviations: AHA, American Heart Association • CI, confidence interval • FSE, fast spin-echo • GRE, gradient-recalled echo • IPH, intraplaque hemorrhage • MRIPH, MR imaging of intraplaque hemorrhage Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Sep 1, 2010

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