Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy
Yasushi Ogasawara 1, Yuiko Sato 1, Shinsuke Narumi 2
, Makoto Sasaki 3, Shunrou Fujiwara 1, Masakazu Kobayashi 1, Kenji Yoshida 1, Yasuo Terayama 2 and Kuniaki Ogasawara 1,*
, Makoto Sasaki 3, Shunrou Fujiwara 1, Masakazu Kobayashi 1, Kenji Yoshida 1, Yasuo Terayama 2 and Kuniaki Ogasawara 1,*
1
Department of Neurosurgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
2
Department of Neurology and Gerontology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
3
Division of Ultra-High Field MRI and Department of Radiology, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
*
Author to whom correspondence should be addressed.
Academic Editor: Michael Henein
Int. J. Mol. Sci. 2016, 17(11), 1791; https://doi.org/10.3390/ijms17111791
Received: 27 July 2016 / Revised: 9 October 2016 / Accepted: 17 October 2016 / Published: 27 October 2016
(This article belongs to the Special Issue Atherosclerosis and Vascular Imaging 2016)
Abstract
The aim of the present study was to determine whether preoperative three-dimensional (3D) fast spin-echo (FSE) T1-weighted magnetic resonance (MR) plaque imaging for severely stenotic cervical carotid arteries could accurately predict the development of artery-to-artery emboli during exposure of the carotid arteries in carotid endarterectomy (CEA). Seventy-five patients underwent preoperative MR plaque imaging and CEA under transcranial Doppler ultrasonography of the ipsilateral middle cerebral artery. On reformatted axial MR image slices showing the maximum plaque occupation rate (POR) and maximum plaque intensity for each patient, the contrast ratio (CR) was calculated by dividing the internal carotid artery plaque signal intensity by the sternocleidomastoid muscle signal intensity. For all patients, the area under the receiver operating characteristic curve (AUC)—used to discriminate between the presence and absence of microembolic signals—was significantly greater for the CR on the axial image with maximum plaque intensity (CRmax intensity) (0.941) than for that with the maximum POR (0.885) (p < 0.05). For 32 patients in whom both the maximum POR and the maximum plaque density were identified, the AUCs for the CR were 1.000. Preoperative 3D FSE T1-weighted MR plaque imaging accurately predicts the development of artery-to-artery emboli during exposure of the carotid arteries in CEA. View Full-TextKeywords:
carotid endarterectomy; artery-to-artery embolism; plaque imaging; three-dimensional; fast spin echo magnetic resonance
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Ogasawara, Y.; Sato, Y.; Narumi, S.; Sasaki, M.; Fujiwara, S.; Kobayashi, M.; Yoshida, K.; Terayama, Y.; Ogasawara, K. Preoperative 3D FSE T1-Weighted MR Plaque Imaging for Severely Stenotic Cervical ICA: Accuracy of Predicting Emboli during Carotid Endarterectomy. Int. J. Mol. Sci. 2016, 17, 1791.
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