Joseph Scott McNally1, Seong-Eun Kim2, John Roberts2, Daniel Nightingale3, Laura K. Findeiss, Gerald S. Treiman4, Dennis L. Parker2
1Radiology, University of Utah, Salt Lake City, UT, United States; 2UCAIR, University of Utah; 3Pathology, VA Salt Lake City Health Care System; 4Surgery, VA Salt Lake City Health Care System
Plaque hemorrhage may discriminate an unstable plaque from a more stable lesion. Patients scheduled for carotid endarterectomy underwent MR imaging with 3D MPRAGE (Magnetization-prepared rapid acquisition with gradient-echo), 3D TOF, 2D DIR T1 and T2 sequences. After carotid endarterectomy, plaque components were identified. MPRAGE hyperintensity correlates with hemorrhage on histology. Variable ages of blood products were detected by the MPRAGE sequence, ranging from recent to remote. Hemorrhage was discriminated from lipid, necrosis, collagen, and calcification using the MPRAGE sequence. This sequence may play an important role in determining which patients benefit from medical management as opposed to surgical intervention.