• J Scott McNally, Hyo-Chun Yoon, Seong-Eun Kim, Krishna K Narra, Michael S McLaughlin, Dennis L Parker, and Gerald S Treiman.
• Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah School of Medicine, Salt Lake City, UT.
• J Neuroimaging. 2015 May 1; 25 (3): 390-6.

Background And PurposeCarotid intraplaque hemorrhage leads to plaque progression and ischemic events. Detection can be accomplished with 3T T1w sequences, but may be limited by false-positive lipid/necrosis. The purpose of this study was threefold: (1) to determine if magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) detects intraplaque hemorrhage versus lipid/necrosis; (2) if 3T MPRAGE image quality is retained at 1.5T; and (3) to determine observer agreement.MethodsMPRAGE positive areas were compared to hemorrhage and lipid/necrosis areas from 100 carotid endarterectomy slides in 12 subjects using multivariable linear regression. Image quality was determined between 3T and 1.5T in 716 carotid arteries using t-tests and multivariable linear regression. Kappa analysis was used to determine agreement.ResultsIntraplaque hemorrhage, not lipid/necrosis, was a significant predictor of MPRAGE positive area before and after adjusting for confounders (slope = .52 vs. .51, P < .001). Image quality at 3T was slightly lower than 1.5T (mean 3.87 vs. 4.34, P < .0001). 3T image quality remained slightly decreased before and after adjusting for confounders (slope = -.46 vs. -.41, P < .001). Kappa values for inter-/intraobserver agreement were .807/.919 at 3T and .803/.871 at 1.5T.ConclusionsCarotid MPRAGE detects intraplaque hemorrhage, not lipid/necrosis. 3T image quality was retained at 1.5T with very good observer agreement.Copyright © 2014 by the American Society of Neuroimaging.

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