Differentiation of symptomatic and asymptomatic carotid intraplaque hemorrhage using 3D high‐resolution diffusion‐weighted stack of stars imaging. (23rd July 2021)

• Record Type: Journal Article
• Authors: Kim, Seong‐Eun; Parker, Dennis L.; Roberts, John A.; Treiman, Gerald S.; Alexander, Matthew; Baradaran, Hediyeh; de Havenon, Adam; McNally, J. Scott
• Is Part Of: NMR in biomedicine. Volume 34:Number 11(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-07-23
• Subjects: 3D stack of stars -- ADC values -- atherosclerosis -- diffusion‐weighted imaging -- intraplaque hemorrhage -- MRI -- stroke -- symptomatic and asymptomatic plaque; Nuclear magnetic resonance -- Periodicals; Magnetic Resonance Spectroscopy -- Periodicals; 574
• DOI: 10.1002/nbm.4582
• Languages: English
• ISSNs: 0952-3480

Abstract

Abstract : Ischemic events related to carotid disease are far more strongly associated with plaque instability than stenosis. 3D high‐resolution diffusion‐weighted (DW) imaging can provide quantitative diffusion measurements on carotid atherosclerosis and may improve detection of vulnerable intraplaque hemorrhage (IPH). The 3D DW‐stack of stars (SOS) sequence was implemented with 3D SOS acquisition combined with DW preparation. After simulation of signals created from 3D DW‐SOS, phantom studies were performed. Three healthy subjects and 20 patients with carotid disease were recruited. Apparent diffusion coefficient (ADC) values were statistically analyzed on three subgroups by using a two‐group comparison Wilcoxon–Mann–Whitney U test with p values less than 0.05: symptomatic versus asymptomatic; IPH‐positive versus IPH‐negative; and IPH‐positive symptomatic versus asymptomatic plaques to determine the relationship with plaque vulnerability. ADC values calculated by 3D DW‐SOS provided values similar to those calculated from other techniques. Mean ADC of symptomatic plaque was significantly lower than asymptomatic plaque (0.68 ± 0.18 vs. 0.98 ± 0.16 x 10 −3 mm 2 /s, p < 0.001). ADC was also significantly lower in IPH‐positive versus IPH‐negative plaque (0.68 ± 0.13 vs. 1.04 ± 0.11 x 10 −3 mm 2 /s, p < 0.001). Additionally, ADC was significantly lower in symptomatic versus asymptomatic IPH‐positive plaque (0.57 ± 0.09 vs. 0.75 ± 0.11 x 10 −3 mm 2 /s, p < 0.001). Our results provide strong evidence that ADC measurements from 3D DW‐SOS correlate with the symptomatic status of extracranial internal carotid artery plaque. Further, ADC improved discrimination of symptomatic plaque in IPH. These data suggest that diffusion characteristics may improve detection of destabilized plaque leading to elevated stroke risk. Abstract : This work provides strong evidence that ADC measurements from 3D DW‐SOS correlate with symptomatic status of extracranial internal carotid artery plaque. Further, ADC further improved discrimination of symptomatic plaque in IPH. These data suggest that diffusion characteristics may improve detection of destabilized plaque leading to elevated stroke risk.