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Abstract #3485

MR Imaging of Carotid Plaque: Correlation Between Contrast-Enhancement and Inflammation at Histopathology

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.