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Comparative Study of Carotid Artherosclerosis between B-mode Ultrasound and High Resolution MRI

Author: DaiYingZuo
Tutor: GuoLiang
School: Suzhou University
Course: Medical Imaging and Nuclear Medicine
Keywords: High resolution MRI carotid artery Atherosclerosis
CLC: R743
Type: Master's thesis
Year: 2010
Downloads: 108
Quote: 0
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Abstract


Background: Recently with the development of society,the morbidity and mortality of the coronary atherosclerotic heart disease is rising yearly。Carotid artery and coronary artery are the most commonly involved. Conventional and comonly used method is still B-mode ultrasound which is limited by its spatial resolution and can not differentiate the component of the plaque. As the development of medical technology, it is found that vulnerable plaque play a key role in stroke or transient ischemia attach. There is growing attention focused on characteriztion of the volnerable plaque paid by physician. Provided with high spatial resolution and muti-weighted protocol, MRI could accurately analyze component of plaque and assess its stability.PartⅠObjective To evaluate the consistency of plaque diagnostic between B-mode ultrasound and high resolution MRI and the influence of image qulity in diagnosis.Methods 30 cases with artherosclerosis underwent both B-mode ultrasound and high resolutin MRI. Two senior radiologist co-operated to analyze mri images and make the diagnosis. According to the quanitity of the plaque found by B-mode ultrasound and high resolution MRI, we can evaluate the consistency of plaque diagnostic between B-mode ultrasound and high resolution MRI.Results Among the 30 patients, the total positive patients found by B-mode ultrasound and high resolution MRI is 29. 1 patient is negative in B-mode ultrasound and high resolution MRI. only 28 patients were found in MRI, 1 patients is missed by mri owning to the figure of plaque which is too shallow and smooth. Meanwhile, 1 patient found by MRI is also missed by B-mode ultrasound because the palque is in high point of internal carotid artery where is too high to be detected by B-mode ultrasound. We use kappa index to evaluate the consistency of plaque diagnostic between B-mode ultrasound and high resolution MRI. The kappa index was o.76,which indicated excellent agreement between B-mode ultrasound and high resolution MRI.Conclusion High resolution MRI is an effective noninvasive diagnositic tool for the detection of carotid artherosclerosis plaque, and the grade derived by high resolution MRI correlated well with B-mode ultrasound.PartⅡObjective To evaluate the feasibility and diagnostic accuracy of high resolution MRI in differetiating the stability of plaque in carotid artery.Methods 16 patients whose stenosis of carotid artery is more than 50% were devided into two groups accroding to clinical materials: stroke or TIA. All kinds of parameters were cmopared between the two groups to assess corrrelation between the characteriztion of the volnerable plaque and clinical materialsResults There were no significant differences found for external vessel areas and plaque areas, suggesting that the plaque burden between the two groups was similar (table 2). In addition, no significant differences were found for size of plaque calcium. Symptomatic lesions had significantly larger lipid cores compared with asymptomatic lesions, both in terms of absolute areas (median area 13 vs 7 mm2; p<0.001) or when expressed as a percentage of total plaque area (median 26% vs 14%;p=0.013). Similarly, symptomatic lesions were more likely to have either a thin or ruptured fibrous cap compared with asymptomatic plaqu(e88.9% vs 28.6%,P=0.035). Symptomatic plaques were much more likely to contain thrombus or haemorrhage compared with asymptomatic plaques(77.8% vs 14.3%,P=0.0406). Conclusion High resolution MRI could accurately analyze component of plaque and assess its stability.

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