An assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery.

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dc.creatorTeng, Zhongzhao
dc.creatorPeng, Wenjia
dc.creatorZhan, Qian
dc.creatorZhang, Xuefeng
dc.creatorLiu, Qi
dc.creatorChen, Shiyue
dc.creatorTian, Xia
dc.creatorChen, Luguang
dc.creatorBrown, Adam J
dc.creatorGraves, Martin J
dc.creatorGillard, Jonathan H
dc.creatorLu, Jianping
dc.date2015-09-04T11:48:43Z
dc.date2015-09-04T11:48:43Z
dc.date2016-07
dc.date.accessioned2026-08-03T03:04:47Z
dc.descriptionOBJECTIVE: Although certain morphological features depicted by high resolution, multi-contrast magnetic resonance imaging (hrMRI) have been shown to be different between culprit and non-culprit middle cerebral artery (MCA) atherosclerotic lesions, the incremental value of hrMRI to define culprit lesions over stenosis has not been assessed. METHODS: Patients suspected with MCA stenosis underwent hrMRI. Lumen and outer wall were segmented to calculate stenosis, plaque burden (PB), volume (PV), length (PL) and minimum luminal area (MLA). RESULTS: Data from 165 lesions (112 culprit and 53 non-culprit) in 139 individuals were included. Culprit lesions were larger and longer with a narrower lumen and increased PB compared with non-culprit lesions. More culprit lesions showed contrast enhancement. Both PB and MLA were better indicators than stenosis in differentiating lesion types (AUC were 0.649, 0.732 and 0.737 for stenosis, PB and MLA, respectively). Combinations of PB, MLA and stenosis could improve positive predictive value (PPV) and specificity significantly. An optimal combination of stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm(2) produced a PPV = 85.7 %, negative predictive value = 54.1 %, sensitivity = 69.6 %, specificity = 75.5 %, and accuracy = 71.5 %. CONCLUSIONS: hrMRI plaque imaging provides incremental information to luminal stenosis in identifying culprit lesions. KEY POINTS: • High resolution MRI provides incremental information in defining culprit MCA atherosclerotic lesions. • Both plaque burden and minimum luminal area are better indicators than stenosis. • An optimal combination includes stenosis ≥ 50 %, PB ≥ 77 % and MLA ≤ 2.0 mm (2) .
dc.descriptionThis research is supported by Shanghai Shenkang Porject SHDC12013110, Shanghai, China; British Heart Foundation (BHF) PG/11/74/29100; and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK. Dr Peng is supported by China Scholarship Council (201306580006), Beijing, China.
dc.descriptionThis is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00330-015-4008-5
dc.formatapplication/pdf
dc.identifierEuropean Radiology 2015. doi:10.1007/s00330-015-4008-5
dc.identifier0938-7994
dc.identifierhttps://www.repository.cam.ac.uk/handle/1810/250503
dc.identifier1432-1084
dc.identifier.urihttps://repo.dare.co.zw/handle/123456789/172509
dc.languageEnglish
dc.languageeng
dc.publisherSpringer Nature
dc.publisherhttps://doi.org/10.1007/s00330-015-4008-5
dc.subjectMagnetic resonance imaging
dc.subjectMiddle cerebral artery
dc.subjectMinimum luminal area
dc.subjectPlaque burden
dc.subjectStenosis
dc.subjectAged
dc.subjectCase-Control Studies
dc.subjectCerebral Angiography
dc.subjectCerebrovascular Disorders
dc.subjectConstriction, Pathologic
dc.subjectDiffusion Magnetic Resonance Imaging
dc.subjectFemale
dc.subjectHumans
dc.subjectImage Processing, Computer-Assisted
dc.subjectIntracranial Arteriosclerosis
dc.subjectMagnetic Resonance Angiography
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMiddle Cerebral Artery
dc.subjectPlaque, Atherosclerotic
dc.subjectPredictive Value of Tests
dc.subjectSensitivity and Specificity
dc.titleAn assessment on the incremental value of high-resolution magnetic resonance imaging to identify culprit plaques in atherosclerotic disease of the middle cerebral artery.
dc.typeArticle

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