Carotid Contrast Enhanced MRA as a Measurement of Atherosclerosis Severity: Direct Comparison with High-Resolution Vessel Wall Imaging

¹Department of Radiology, University of Washington, Seattle, WA, USA; ²Department of Radiology, Beijing Anzhen Hospital, Beijing, China; ³Department of Surgery, University of Washington, Seattle, WA, USA

We sought to assess correlations between MRA, plaque burden and high-risk plaque features in a clinical atherosclerosis population. Subjects (n=66) with >50% carotid stenosis measured by ultrasound in at least one carotid artery, underwent bilateral contrast-enhanced carotid MRA at 3.0T to determine the degree of stenosis and bilateral carotid MRI to identify plaque burden, composition and fibrous cap status. There was a moderate positive correlation between degree of stenosis and plaque burden, but a weak correlation with plaque composition and cap status. Furthermore, high-risk plaque features were commonly observed in arteries with no or minimal stenosis. These findings suggest a critical role for vessel wall imaging to assess the risk of carotid atherosclerosis for future ischemic events.