Cervical carotid plaque evaluation using 3D T1-weighted black-blood magnetic resonance imaging: Comparison of turbo field-echo and turbo spin-echo sequences

Abstract

PurposeTo compare the capability of three-dimensional (3D) T1-weighted turbo field-echo (TFE) black-blood (BB) magnetic resonance imaging (MRI) and turbo-spin echo (TSE) BB MRI for discerning carotid plaques and the difference of signal intensities of the plaques from that of adjacent muscle in patients with cervical carotid stenosis. MethodsCervical carotid stenosis was evaluated by 3.0-T MR in 43 patients (38 men and 5 women; age, 36–83 years; mean age, 70 years) during 8 months. The carotid BB MRI comprised 3D T1-weighted TSE BB (T1-TSEBB) and 3D T1-weighted TFE BB (T1-TFEBB) sequences. The delineation of the carotid plaque border was evaluated in comparison with digital subtraction angiography (DSA). The border between the plaque and vessel lumen was rated visually (4-point analysis) and quantitatively (contrast-to-noise ratio). The signal-intensity ratio (SIR) of the plaque to the adjacent muscle was also measured. Data of 3D T1-TSEBB and 3D T1-TFEBB were compared statistically using the Wilcoxon signed-rank test. ResultsVisual and quantitative analyses revealed that the border between the plaque and vessel lumen was better delineated on 3D T1-TSEBB MRI than on 3D T1-TFEBB MRI (p<0.01, respectively). SIR of the plaque-to-adjacent muscle was higher on 3D T1- TFEBB MRI than on 3D T1-TSEBB MRI (p<0.05). High signal plaques with a SIR of >1.5 were underestimated on 3D T1-TSEBB MRI. Conclusions3D T1-TSEBB MRI was superior to 3D T1-TFEBB MRI for delineating carotid plaques; however, high signal plaques were underestimated on 3D T1-TSEBB MRI.