Our goal in this project is to overcome major barriers preventing MRI from being the clinical standard for carotid disease evaluation. Carotid MRI is unique in that it has the potential to accurately measure vulnerable plaque markers in addition to the clinically relevant measurement of percent diameter stenosis. In addition to carotid stenosis, studies using MRI in the research setting have found that carotid intraplaque inflammation (IPI), intraplaque hemorrhage (IPH), necrotic core (NC), and fibrous cap (FC) thickness and disruption are important stroke risk factors. Although MRI has the potential to measure these factors, major barriers still exist to using carotid MRI in the clinical setting. These include 1) he lack of a coil specific to the anatomic location of the carotid bifurcation in all patients and 2) he lack of high-resolution MRI sequences to accurately measure lumen, stenosis, and plaque components in the presence of respiratory, cardiac, and swallowing motion. In this project we will: 1) develop a novel carotid imaging coil with modular interchangeable arrays on formers that match the range of patient neck anatomy encountered; 2) develop innovative pulse sequences to accurately measure carotid lumen, stenosis and plaque components; 3) develop pulse sequence methods and reconstruction algorithms to detect and correct motion-corrupted measurements; and 4) validate these results by comparison with histology. The development of tailor-made subject fitting RF coils will increase SNR and allow higher spatial and temporal resolution. This increased SNR from the modular coils coupled with motion- robust sequences will increase accuracy of identifying in-vivo plaque components. This will lay the foundation for future studies using carotid MRI to optimally characterize stroke risk and monitor treatment effects geared toward decreasing IPI, IPH, NC, and stabilizing the FC. These methods that conveniently, consistently, and accurately depict carotid lumen and plaque components will overcome the major barriers to the use of MRI as the clinical standard in characterizing carotid disease. This will facilitate the transition of carotid MRI from the research setting where MRI methods have been developed to the general clinic where benefit to the individual patient will be obtained and costs to society will ultimately be reduced.
Carotid MRI is unique in that it has the potential to accurately measure vulnerable plaque markers in addition to the clinically relevant measurement of percent diameter stenosis. The goal in this project is to improve MRI pulse sequences and coils to overcome barriers that impede carotid MRI from being the primary carotid imaging method used clinically.
