• Yoo Jeong Yim, Yeon Hyeon Choe, Yonghyeh Ko, Sung Tae Kim, Keon Ha Kim, Pyoung Jeon, Hong Sik Byun, and Dong-Ik Kim.
• Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• J Magn Reson Imaging. 2008 Jun 1; 27 (6): 1341-6.

PurposeTo evaluate the value of the high signal intensity halo sign as a new marker of a fresh or recent intraplaque hemorrhage on the maximum intensity projection (MIP) images of time-of-flight (TOF) MR angiography.Materials And MethodsA total of 135 consecutive patients were included in this study. High-resolution MRI using 3-inch surface coils was performed on a 1.5T scanner before the carotid endarterectomy. TOF MR angiograms and T2-weighted, T1-weighted pre- and postcontrast fast spin echo images were obtained. The surgical and pathological findings of the carotid artery were analyzed and correlated with the MRI findings.ResultsA total of 42 atheromas (31.1%) had a fresh or recent intraplaque hemorrhage on the surgicopathological findings. A total of 38 (90.5%) of these patients showed high signal intensity halo around the carotid artery on the MIP images of TOF MR angiography. The high signal intensity halo sign, compared with the surgical and histopathological findings, demonstrated a sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 83%, 72%, and 95%, respectively, with a 95% confidence interval (CI) in the detection of an intraplaque hemorrhage. The multisequence approach suggested the presence of an intraplaque hemorrhage with a sensitivity, specificity, positive predictive value, and negative predictive value of 93%, 85%, 74%, and 96%, respectively, with a 95% CI.ConclusionHigh signal intensity halo around the carotid artery on the MIP images of TOF MR angiography is useful in the noninvasive detection of a fresh or recent carotid intraplaque hemorrhage.

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