Francesco Sardanelli1,2, Giacomo Davide Edoardo Papini1, Stefania Tritella1, Biagio Cotticelli1, Giovanni Nano3, Claudio Clemente4, Giovanni Di Leo1
1Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; 2Medical and Surgical Science, University of Milan School of Medicine, Milan, Italy; 3Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; 4Unit of Pathology, Istituto Clinico Sant'Ambrogio, Milan, Italy
Twenty-two patients underwent preoperative 1.5-T MRA and unenhanced axial T1-weighted gradient-echo sequence centered on carotid bifurcation before and 3 minutes after contrast injection (gadobenate dimeglumine, 0.1 mmol/kg). Using native and subtracted images, plaque enhancement was scored as 0 (absent), 1 (focal), or 2 (extended). At histopathology, inflammatory cell infiltration was graded as 0 (absent/minimal), 1 (focal), or 2 (extended). Weighted Cohen k resulted 0.57 (moderate agreement). Sensitivity was 78%, specificity 85%, and accuracy 82%. No significant correlation was observed between stenosis degree and plaque inflammation at histopathology. Wall enhancement is a reliable marker of plaque inflammation, independently from stenosis degree.