MRI-derived measurements of fibrous-cap and lipid-core thickness: the potential for identifying vulnerable carotid plaques in vivo

Neuroradiology. 2004 Sep;46(9):738-43. doi: 10.1007/s00234-004-1247-6.


Vulnerable plaques have thin fibrous caps overlying large necrotic lipid cores. Recent studies have shown that high-resolution MR imaging can identify these components. We set out to determine whether in vivo high-resolution MRI could quantify this aspect of the vulnerable plaque. Forty consecutive patients scheduled for carotid endarterectomy underwent pre-operative in vivo multi-sequence MR imaging of the carotid artery. Individual plaque constituents were characterised on MR images. Fibrous-cap and lipid-core thickness was measured on MRI and histology images. Bland-Altman plots were generated to determine the level of agreement between the two methods. Multi-sequence MRI identified 133 corresponding MR and histology slices. Plaque calcification or haemorrhage was seen in 47 of these slices. MR and histology derived fibrous cap-lipid-core thickness ratios showed strong agreement with a mean difference between MR and histology ratios of 0.02 (+/- 0.04). The intra-class correlation coefficient between two readers for measurements was 0.87 (95% confidence interval, 0.73 and 0.93). Multi-sequence, high-resolution MR imaging accurately quantified the relative thickness of fibrous-cap and lipid-core components of carotid atheromatous plaques. This may prove to be a useful tool to characterise vulnerable plaques in vivo.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carotid Artery, Common / pathology
  • Carotid Stenosis / pathology*
  • Female
  • Fibrosis
  • Humans
  • Image Processing, Computer-Assisted
  • Lipids
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Rupture, Spontaneous / pathology


  • Lipids