Multi-contrast atherosclerosis characterization (MATCH) of carotid plaque with a single 5-min scan: Technical development and clinical feasibility

Background: multi-contrast weighted imaging is a commonly used cardiovascular magnetic resonance (cmr) protocol for characterization of carotid plaque composition. however,this approach is limited in several aspects including low slice resolution,long scan time,image mis-registration,and complex image interpretation. in this work,a 3d cmr technique,named multi-contrast atherosclerosis characterization (match),was developed to mitigate the above limitations.methods. match employs a 3d spoiled segmented fast low angle shot readout to acquire data with three different contrast weightings in an interleaved fashion. the inherently co-registered image sets,hyper t1-weighting,gray blood,and t2-weighting,are used to detect intra-plaque hemorrhage (iph),calcification (ca),lipid-rich necrotic core (lrnc),and loose-matrix (lm). the match sequence was optimized by computer simulations and testing on four healthy volunteers and then evaluated in a pilot study of six patients with carotid plaque,using the conventional multi-contrast protocol as a reference.results: on match images,the major plaque components were easy to identify. spatial co-registration between the three image sets with match was particularly helpful for the reviewer to discern co-existent components in an image and appreciate their spatial relation. based on cohen's kappa tests,moderate to excellent agreement in the image-based or artery-based component detection between the two protocols was obtained for lrnc,iph,ca,and lm,respectively. compared with the conventional multi-contrast protocol,the match protocol yield significantly higher signal contrast ratio for iph (3.1 ± 1.3 vs. 0.4 ± 0.3,p < 0.001) and ca (1.6 ± 1.5 vs. 0.7 ± 0.6,p = 0.012) with respect to the vessel wall.conclusions: to the best of our knowledge,the proposed match sequence is the first 3d cmr technique that acquires spatially co-registered multi-contrast image sets in a single scan for characterization of carotid plaque composition. our pilot clinical study suggests that the match-based protocol may outperform the conventional multi-contrast protocol in several respects. with further technical improvements and large-scale clinical validation,match has the potential to become a cmr method for assessing the risk of plaque disruption in a clinical workup. © 2014 fan et al.;licensee biomed central.