Abstract

BackgroundThe benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations.MethodsIn order to provide a methodology that allows such an investigation in detail, numerical simulations of a T1-weighted, contrast-enhanced, 2D MRI sequence were employed. Both the slice thickness (2 mm, 1 mm, and 0.5 mm) and the in plane acquired voxel size (0.62x0.62 mm2 and 0.31x0.31 mm2) were varied. This virtual MRI approach was applied to 8 histology-based 3D patient carotid atherosclerotic plaque models.ResultsA decreased slice thickness did not result in major improvements in lumen, vessel wall, and lipid-rich necrotic core size measurements. At 0.62x0.62 mm2 in-plane, only a 0.5 mm slice thickness resulted in improved minimum fibrous cap thickness measurements (a 2–3 fold reduction in measurement error) and only marginally improved peak cap stress computations. Acquiring voxels of 0.31x0.31 mm2 in-plane, however, led to either similar or significantly larger improvements in plaque component quantification and computed peak cap stress.ConclusionsThis study provides evidence that for currently-used 2D carotid MRI protocols, a decreased slice thickness might not be more beneficial for plaque measurement accuracy than a decreased in-plane voxel size. The MRI simulations performed indicate that not a reduced slice thickness (i.e. more isotropic imaging), but the acquisition of anisotropic voxels with a relatively smaller in-plane voxel size could improve carotid plaque quantification and computed peak cap stress accuracy.

Highlights

  • Carotid magnetic resonance imaging (MRI) is an established modality to image atherosclerotic plaques at the common carotid artery bifurcation [1,2,3]

  • A decreased slice thickness did not result in major improvements in lumen, vessel wall, and lipid-rich necrotic core size measurements

  • At 0.62x0.62 mm2 in-plane, only a 0.5 mm slice thickness resulted in improved minimum fibrous cap thickness measurements (a 2–3 fold reduction in measurement error) and only marginally improved peak cap stress computations

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Summary

Introduction

Carotid magnetic resonance imaging (MRI) is an established modality to image atherosclerotic plaques at the common carotid artery bifurcation [1,2,3]. In 2D protocols, anisotropic voxels are acquired with a slice thickness larger than the in-plane acquired voxel size. Acquiring anisotropic voxels can improve the signal-tonoise ratio (SNR) and/or decrease the total scan time while maintaining a small in-plane voxel size to facilitate visualization in a cross-sectional plane [6,18]. Vulnerable plaque parameters—being LRNC size, minimum FC thickness, and peak cap stress—the potential benefits of a decreased slice thickness in MRI have not been investigated. The benefits of a decreased slice thickness and/or in-plane voxel size in carotid MRI for atherosclerotic plaque component quantification accuracy and biomechanical peak cap stress analysis have not yet been investigated in detail because of practical limitations

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