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High field MR carotid vessel wall imaging: reproducibility of five different MR-weightings

Introduction

Magnetic Resonance Imaging (MRI) has emerged as a promising noninvasive imaging modality for the serial assessment of vessel wall thickness in the carotid artery as an early marker of atherosclerosis. For clinical application of this technique, Scan-Rescan reproducibility is paramount. Currently, a multicontrast protocol, including a combination of MR-weightings is used as reference standard for quantitative and morphologic measurements.

Purpose

To investigate Scan-Rescan reproducibility for each of the commonly used weightings analyzed separately. To investigate which of the MR-weightings approximates best the combined multicontrast protocol (reference standard).

Methods

5 healthy volunteers (60% male, mean age=28years) underwent repeated MRI examinations of the left carotid artery with five contrast-weighted scans to image lumen and vessel wall (Table 1). The scan and a rescan were acquired using a 3T (Philips) MRI scanner. A standard phased-array coil with two flexible elements of 14×17cm was used to obtain nine transverse imaging sections of the left carotid artery with identical in-plane resolution (0.46×0.46mm2). Scan-Rescan analysis was performed in the third slice of the imaging stack, representing a slice in the common carotid artery. An example is provided in Figure 1. Manual contour segmentation of the lumen and vessel wall was performed using in-house developed software (VesselMASS). Vessel wall area (mm2) and lumen area (mm2) were assessed by one blinded observer for the different contrast weightings and compared with the rescan acquisition. Furthermore, vessel wall- and lumen areas from the different contrast weightings were compared with the reference standard.

Table 1 Carotid Imaging Protocol at 3T: Scan Parameters
Figure 1
figure1

An example of the co-registered contrast-weightings and 3D time-of-flight. The red line on the sagittal view of the carotid bifurcation indicates position of the analyzed slices.

Results

Reproducibility of the repeated assessment was high for all MR-weightings, for both lumen area and vessel wall areas. (Table 2). The Bland-Altman plot for vessel wall area, is shown in Figure 2 for Scan-Rescan reproducibility. Highest reproducibility was found for the T1-TFE and T2-TSE sequences.

Table 2 Table 2
Figure 2
figure2

Bland-Altman Plot: Scan-Rescan Reproducibility (Vessel Wall Area)

T1-TFE showed highest correlation for lumen (r=0.97) and vessel wall area (r=0.90) assessment when compared with the reference standard.

Conclusion

This pilot Scan-Rescan study showed best reproducibility of lumen and vessel wall area assessment for the T1-TFE and T2-TSE weightings. T1-TFE showed highest correlation to the reference standard.

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Correspondence to Eleanore S Kroner.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Kroner, E.S., Westenberg, J.J., van der Geest, R.J. et al. High field MR carotid vessel wall imaging: reproducibility of five different MR-weightings. J Cardiovasc Magn Reson 13, O13 (2011). https://doi.org/10.1186/1532-429X-13-S1-O13

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Keywords

  • Vessel Wall
  • Magnetic Resonance Image Examination
  • Lumen Area
  • Left Carotid Artery
  • Vessel Wall Thickness