Table 1. Validation of carotid MRI.
| Plaque component | MR sequence | Sensitivity/specificity or correlation with histology | Agreement |
|---|---|---|---|
| IPH | MPRAGE | 84%/84% (29) | |
| MPRAGE | 93%/96% (7) | ||
| SNAP versus MPRAGE | κ=0.82 (30) | ||
| Meta-analysis | 87%/92% (31) | ||
| LRNC | Pre- and post-contrast T1W | 98%/100 (32). Strongly correlated with histology (Pearson’s r=0.84, P<0.001) (33) | Inter-observer agreement (ICC, 0.89; 95% CI: 0.81–0.93) (33) |
| T2W (if contrast injection is contraindicated) | 85%/92% (34), 90%/84% (35), 95%/76% (36). Correlation with histology (r=0.75; P<0.001) (36) | Inter-reader reproducibility for area measurements of LRNC (ICC: 0.92, 95% CI: 0.82–0.97) (36) | |
| TRFC | Pre- and post-contrast T1W | Correlation with histology (r=0.80, P<0.001) (33) | Inter-observer agreement (ICC: 0.78; 95% CI: 0.68–0.86) (33) |
| T2W or TOF if contrast injection is contraindicated | 90%/84% (35) | Agreement with histology κ=0.87 (37) | |
| Calcifications | Bright blood image and in addition at least one other weighting | With histology (r=0.74; P<0.001) (36) | Inter-observer agreement (ICC: 0.9; 95% CI: 0.77–0.96). Agreement with histology (κ=0.75, 95% CI: 0.66–0.84) (36) |
| Ulceration | CE-MRA | Inter-observer agreement (κ=0.86, 95% CI: 0.77–0.95) (38) | |
| TOF (if contrast injection is contraindicated) | TOF: 81%/90% (39) | (κ=0.72, 95% CI: 0.58–0.86) (38) | |
| SNAP vs. conventional multi-contrast | (κ=0.82, 95% CI: 0.65–0.99) (40) |
MRI, magnetic resonance imaging; IPH, intraplaque hemorrhage; LRNC, lipid-rich necrotic core; TRFC, thin or ruptured fibrous cap; MPRAGE, magnetization-prepared rapid acquisition gradient echo; SNAP, simultaneous non-contrast angiography and IPH; TOF, time of flight; CE-MRA, contrast-enhanced MR angiography.