• Vincent C Cappendijk, Alfons G H Kessels, Sylvia Heeneman, Kitty B J M Cleutjens, Geert Willem H Schurink, Rob J Th J Welten, Werner H Mess, Robert-Jan van Suylen, Tim Leiner, Mat J A P Daemen, Jos M A van Engelshoven, and M Eline Kooi.
• University Hospital Maastricht, Department of Radiology, Maastricht, The Netherlands. vca@rdia.azm.nl
• J Magn Reson Imaging. 2008 Jun 1; 27 (6): 1356-61.

PurposeTo investigate the potential difference in the size of the lipid-rich necrotic core (LRNC) in carotid plaques of symptomatic patients versus asymptomatic patients. Pathological studies established that a large LRNC is an important feature of vulnerable atherosclerotic plaque. Previously, we have demonstrated a high correlation between semiquantitative analysis of the LRNC size in T1-weighted (w) turbo field echo (TFE) MR images and histology.Materials And MethodsThirty-seven patients with carotid stenosis >70% with (n = 26) or without (n = 11) symptoms were included. Three independent MR readers quantified the amount of LRNC with a T1w TFE pulse sequence. The relative amount of LRNC (LRNC score) was defined as sum of cross-sectional area percentages LRNC per carotid plaque.ResultsInterreader agreement for the three MR readers was good, with an intraclass correlation coefficient (ICC, 95% confidence interval [CI]) of 0.72 (0.57-0.83). All three MR readers on average found a larger LRNC in the symptomatic group of patients, although this was not statistically significant. The mean LRNC score was 116 +/- 129 and 59 +/- 62 for symptomatic and asymptomatic patients, respectively (P = 0.13). Symptomatic patients showed wide ranges in LRNC scores (0-424), while the range was much lower in the asymptomatic group (0-170).ConclusionSingle-sequence T1w TFE may be a promising technique to study atherosclerotic plaque at risk of stroke. Larger studies are warranted to confirm these promising results.2008 Wiley-Liss, Inc

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