Atherosclerosis T1-weighted characterization (CATCH): evaluation of the accuracy for identifying intraplaque hemorrhage with histological validation in carotid and coronary artery specimens

J Cardiovasc Magn Reson. 2018 Apr 26;20(1):27. doi: 10.1186/s12968-018-0447-x.


Background: Coronary high intensity plaques (CHIPs) detected using cardiovascular magnetic resonance (CMR) coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) have been shown to be positively associated with high-risk morphology observed on intracoronary optical coherence tomography (OCT). This study sought to validate whether CHIPs detected on CATCH indicate the presence of intraplaque hemorrhage (IPH) through ex vivo imaging of carotid and coronary plaque specimens, with histopathology as the standard reference.

Methods: Ten patients scheduled to undergo carotid endarterectomy underwent CMR with the conventional T1-weighted (T1w) sequence. Eleven carotid atherosclerotic plaques removed at carotid endarterectomy and six coronary artery endarterectomy specimens removed from patients undergoing coronary artery bypass grafting (CABG) were scanned ex vivo using both the conventional T1w sequence and CATCH. Both in vivo and ex vivo images were examined for the presence of IPH. The sensitivity, specificity, and Cohen Kappa (k) value of each scan were calculated using matched histological sections as the reference. k value between each scan in the discrimination of IPH was also computed.

Results: A total of 236 in vivo locations, 328 ex vivo and matching histology locations were included for the analysis. Sensitivity, specificity, and k value were 76.7%, 95.3%, and 0.75 for in vivo T1w imaging, 77.2%, 97.4%, and 0.78 for ex vivo T1w imaging, and 95.0%, 92.1%, and 0.84 for ex vivo CATCH, respectively. Moderate agreement was reached between in vivo T1w imaging, ex vivo T1w imaging, and ex vivo CATCH for the detection of IPH: between in vivo T1w imaging and ex vivo CATCH (k = 0.68), between ex vivo T1w imaging and ex vivo CATCH (k = 0.74), between in vivo T1w imaging and ex vivo T1w imaging (k = 0.83). None of the coronary artery plaque locations showed IPH.

Conclusion: This study demonstrated that carotid CHIPs detected by CATCH can be used to assess for IPH, a high-risk plaque feature.

Keywords: CATCH; Coronary high intensity plaques (CHIPs); Intraplaque hemorrhage; T1w imaging.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Biopsy
  • Carotid Arteries / diagnostic imaging*
  • Carotid Arteries / pathology
  • Carotid Arteries / surgery
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / surgery
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / surgery
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / pathology
  • Coronary Vessels / surgery
  • Endarterectomy, Carotid
  • Female
  • Hemorrhage / diagnostic imaging*
  • Hemorrhage / pathology
  • Hemorrhage / surgery
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic*
  • Predictive Value of Tests
  • Preliminary Data
  • Reproducibility of Results