Cappendijk Vincent C, Cleutjens Kitty B J M, Heeneman Sylvia, Schurink Geert Willem H, Welten Rob J Th J, Kessels Alfons G H, van Suylen Robert J, Daemen Mat J A P, van Engelshoven Jos M A, Kooi M Eline
Department of Radiology, Cardiovascular Research Institute Maastricht (CARIM), University Hospital of Maastricht, The Netherlands.
J Magn Reson Imaging. 2004 Jul;20(1):105-10. doi: 10.1002/jmri.20060.
To investigate the performance of high-resolution T1-weighted (T1w) turbo field echo (TFE) magnetic resonance imaging (MRI) for the identification of the high-risk component intraplaque hemorrhage, which is described in the literature as a troublesome component to detect.
An MRI scan was performed preoperatively on 11 patients who underwent carotid endarterectomy because of symptomatic carotid disease with a stenosis larger than 70%. A commonly used double inversion recovery (DIR) T1w turbo spin echo (TSE) served as the T1w control for the T1w TFE pulse sequence. The MR images were matched slice by slice with histology, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the MR images were calculated. Additionally, two readers, who were blinded for the histological results, independently assessed the MR slices concerning the presence of intraplaque hemorrhage.
More than 80% of the histological proven intraplaque hemorrhage could be detected using the TFE sequence with a high interobserver agreement (Kappa = 0.73). The TFE sequence proved to be superior to the TSE sequence concerning SNR and CNR, but also in the qualitative detection of intraplaque hemorrhage. The false positive TFE results contained fibrous tissue and were all located outside the main plaque area.
The present study shows that in vivo high-resolution T1w TFE MRI can identify the high-risk component intraplaque hemorrhage with a high detection rate in patients with symptomatic carotid disease. Larger clinical trials are warranted to investigate whether this technique can identify patients at risk for an ischemic attack.
研究高分辨率T1加权（T1w）涡轮场回波（TFE）磁共振成像（MRI）在识别斑块内出血高危成分方面的性能，斑块内出血在文献中被描述为一种难以检测的成分。
对11例因症状性颈动脉疾病且狭窄率大于70%而接受颈动脉内膜切除术的患者进行术前MRI扫描。常用的双反转恢复（DIR）T1w涡轮自旋回波（TSE）作为T1w TFE脉冲序列的T1w对照。将MR图像与组织学逐片匹配，并计算MR图像的信噪比（SNR）和对比噪声比（CNR）。此外，两名对组织学结果不知情的阅片者独立评估MR切片中是否存在斑块内出血。
使用TFE序列可检测出超过80%经组织学证实的斑块内出血，观察者间一致性较高（Kappa = 0.73）。在SNR和CNR方面，TFE序列优于TSE序列，在斑块内出血的定性检测方面也是如此。TFE的假阳性结果包含纤维组织，且均位于主要斑块区域之外。
本研究表明，对于有症状的颈动脉疾病患者，活体高分辨率T1w TFE MRI能够以较高的检出率识别斑块内出血高危成分。有必要进行更大规模的临床试验，以研究该技术能否识别有缺血性发作风险的患者。
